Provider Demographics
NPI:1083311609
Name:MITCHELL, KELSEY ELISABETH (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:ELISABETH
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6913 COLLEY RD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-3921
Mailing Address - Country:US
Mailing Address - Phone:813-909-5543
Mailing Address - Fax:
Practice Address - Street 1:8787 BRYAN DAIRY RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1251
Practice Address - Country:US
Practice Address - Phone:727-394-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-14
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024343363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner