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NPI Code Detail

MEDICARE: KELSEY GRESS

MEDICARE: KELSEY GRESS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist1666ND
2235Z00000XSpeech-Language Pathologist18186FL

General Provider Information

NPI Number : 1114495207
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY GRESS
Provider Business Mailing Address
First Line : 8451 GATE PKWY W APT 1145
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-4104
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7723 JASPER AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-7719
Country : US
Telephone Number : 904-725-8044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2018
Last Update Date : 08/03/2020

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Directions to “ KELSEY GRESS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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