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NPI Code Detail

MEDICARE: KELSEY SHELL SLPA

MEDICARE: KELSEY SHELL SLPA
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
12355S0801XSpeech-Language AssistantSI6512FL

General Provider Information

NPI Number : 1447018916
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY SHELL SLPA
Provider Business Mailing Address
First Line : 22391 FLORA PARKE XING UNIT A
Second Line :
City : FERNANDINA BEACH
State : FL
Zip : 32034-8005
Country : US
Telephone Number : 904-321-9054
Fax Number :
Provider Business Practice Location Address
First Line : 22391 FLORA PARKE XING UNIT A
Second Line :
City : FERNANDINA BEACH
State : FL
Zip : 32034-8005
Country : US
Telephone Number : 904-321-9054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2024
Last Update Date : 03/11/2024

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Directions to “ KELSEY SHELL SLPA” Practice Location

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