Provider Demographics
NPI:1255862215
Name:NANCARROW, KELSEY (BS, RPSGT, RST)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:NANCARROW
Suffix:
Gender:F
Credentials:BS, RPSGT, RST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 CHEVY CHASE CIR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3601
Mailing Address - Country:US
Mailing Address - Phone:832-202-8499
Mailing Address - Fax:
Practice Address - Street 1:611 CHEVY CHASE CIR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3601
Practice Address - Country:US
Practice Address - Phone:832-202-8499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1992237820OtherNPI