MEDICARE: ALYSON MAY KELSEY PA-C, MED, LAT, ATC

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
1	363A00000X	Physician Assistant	8494-23	WI
2	2255A2300X	Athletic Trainer	1481-39	WI

General Provider Information

NPI Number	:	1891135976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON MAY KELSEY PA-C, MED, LAT, ATC

Provider Business Mailing Address
First Line	:	10212N N GREENWOOD LN
Second Line	:
City	:	HAYWARD
State	:	WI
Zip	:	54843-7220
Country	:	US
Telephone Number	:	715-634-6542
Fax Number	:	715-634-7055

Provider Business Practice Location Address
First Line	:	10212N N GREENWOOD LN
Second Line	:
City	:	HAYWARD
State	:	WI
Zip	:	54843-7220
Country	:	US
Telephone Number	:	715-634-6520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2013
Last Update Date	:	03/25/2026

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