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NPI Code Detail

MEDICARE: KELSEY R BARBERO PA-C

MEDICARE:   KELSEY R BARBERO  PA-C
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
1363A00000XPhysician Assistant085007550IL

General Provider Information

NPI Number : 1194357665
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY R BARBERO PA-C
Provider Business Mailing Address
First Line : 1215 VANDALIA ST
Second Line :
City : COLLINSVILLE
State : IL
Zip : 62234-4060
Country : US
Telephone Number : 618-343-6015
Fax Number : 618-578-5759
Provider Business Practice Location Address
First Line : 1215 VANDALIA ST
Second Line :
City : COLLINSVILLE
State : IL
Zip : 62234-4060
Country : US
Telephone Number : 618-343-6015
Fax Number : 618-578-5759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2020
Last Update Date : 07/19/2022

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Directions to “ KELSEY R BARBERO PA-C” Practice Location

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