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General NPI Number Information
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NPI Number | 1417860420
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Entity Type | Individual
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Provider Name | KELSEY CARROLL FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 227 VALLEY VIEW DR
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City | WAVERLY
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State | OH
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Zip | 45690-9135
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Country | US
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Telephone | 740-947-8777
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Fax |
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Provider Business Mailing Address
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Address Line | 8009 DENVER RD
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City | WAVERLY
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State | OH
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Zip | 45690-9535
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Country | US
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Telephone | 740-289-2371
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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 | RN404043
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License Number State | OH
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