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General NPI Number Information
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NPI Number | 1851086243
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Entity Type | Organization
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Legal Business Name | KELSEY HOUSE, APRN LLC
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 3065 TOWN TER
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City | NORTH PORT
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State | FL
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Zip | 34286-4363
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Country | US
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Telephone | 239-989-7375
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Fax | 239-215-1143
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Provider Business Mailing Address
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Address Line | 3065 TOWN TER
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City | NORTH PORT
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State | FL
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Zip | 34286-4363
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Country | US
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Telephone | 239-989-7375
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Fax | 239-215-1143
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KELSEY LYNNE HOUSE
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Credential | APRN
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Telephone | 239-989-8737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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