Provider Demographics
NPI:1174399117
Name:MARTEL, KELSEY ROSE (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:ROSE
Last Name:MARTEL
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:ROSE
Other - Last Name:GAMMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1893 SAINT MATTHEWS RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2403
Mailing Address - Country:US
Mailing Address - Phone:919-301-3200
Mailing Address - Fax:
Practice Address - Street 1:1893 SAINT MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2403
Practice Address - Country:US
Practice Address - Phone:919-301-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily