Provider Demographics
NPI:1114573417
Name:STRICKLAND, KELSEY (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 GIBBS ST
Mailing Address - Street 2:
Mailing Address - City:RAVENSWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26164-1005
Mailing Address - Country:US
Mailing Address - Phone:304-634-6323
Mailing Address - Fax:
Practice Address - Street 1:4619 KANAWHA AVE SW
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1319
Practice Address - Country:US
Practice Address - Phone:304-400-4545
Practice Address - Fax:304-400-4546
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV104130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily