Healthcare Provider Details

I. General information

NPI: 1053131144
Provider Name (Legal Business Name): KELSEY MICHELLE SINOR NP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 10/14/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 LEE HWY STE B
DUBLIN VA
24084-3802
US

IV. Provider business mailing address

5936 CRUMPACKER DR
ROANOKE VA
24012-8836
US

V. Phone/Fax

Practice location:
  • Phone: 540-674-4560
  • Fax:
Mailing address:
  • Phone: 214-729-7125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024191461
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: