=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578936092
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KELLY FRANCIS PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/05/2015
-----------------------------------------------------
Last Update Date | 02/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2500 CANTERBURY DR STE 112
-----------------------------------------------------
City | HAYS
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67601-2258
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-261-7599
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 21686
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33622-1686
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-468-2211
-----------------------------------------------------
Fax | 877-868-4888
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AS0400X
-----------------------------------------------------
Taxonomy Name | Surgical Physician Assistant
-----------------------------------------------------
License Number | PAC9109288
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363AS0400X
-----------------------------------------------------
Taxonomy Name | Surgical Physician Assistant
-----------------------------------------------------
License Number | 1503041
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------