Provider Demographics
NPI:1083663413
Name:KELSKE, JANET ELIZABETH (MS,CPNP,ANP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ELIZABETH
Last Name:KELSKE
Suffix:
Gender:F
Credentials:MS,CPNP,ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 W MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:WEST BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8222
Mailing Address - Country:US
Mailing Address - Phone:631-665-2700
Mailing Address - Fax:631-665-0290
Practice Address - Street 1:649 W MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8222
Practice Address - Country:US
Practice Address - Phone:631-665-2700
Practice Address - Fax:631-665-0290
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351271-0163W00000X
NYF303752-1363LA2200X
NYF381109-0363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics