Provider Demographics
NPI:1013556745
Name:BABB, KELSEY CHIEKO (LM,CPM)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:CHIEKO
Last Name:BABB
Suffix:
Gender:F
Credentials:LM,CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 PARK DR APT 4
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77023-1440
Mailing Address - Country:US
Mailing Address - Phone:281-300-8354
Mailing Address - Fax:
Practice Address - Street 1:5025 PARK DR APT 4
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-1440
Practice Address - Country:US
Practice Address - Phone:281-300-8354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-28
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99383176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife