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General NPI Number Information
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NPI Number | 1366339194
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Entity Type | Individual
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Provider Name | KELSEY HAYNES CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 2038 SPRINGDALE LN
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City | BIRMINGHAM
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State | AL
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Zip | 35217-2028
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Country | US
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Telephone | 205-841-7665
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Fax |
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Provider Business Mailing Address
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Address Line | 551 TRIPLE CREEK DR
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City | MORRIS
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State | AL
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Zip | 35116-1738
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Country | US
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Telephone | 205-370-5744
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-139002
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License Number State | AL
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