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NPI Code Detail

MEDICARE: KELSIE JOHN SW

MEDICARE: KELSIE JOHN SW
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
1104100000XSocial WorkerBP00945788WV

General Provider Information

NPI Number : 1891372231
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSIE JOHN SW
Provider Business Mailing Address
First Line : 971 HARRISON AVE
Second Line :
City : ELKINS
State : WV
Zip : 26241-3608
Country : US
Telephone Number : 304-636-9450
Fax Number : 304-636-2282
Provider Business Practice Location Address
First Line : 971 HARRISON AVE
Second Line :
City : ELKINS
State : WV
Zip : 26241-3608
Country : US
Telephone Number : 304-636-9450
Fax Number : 304-636-2282
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2021
Last Update Date : 03/24/2021

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Directions to “ KELSIE JOHN SW” Practice Location

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