Provider Demographics
NPI:1417320664
Name:AMENT, KELSEY JANELLE-MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:JANELLE-MARIE
Last Name:AMENT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 ROCK MERRITT AVENUE
Mailing Address - Street 2:
Mailing Address - City:FORT LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:910-907-8481
Mailing Address - Fax:
Practice Address - Street 1:2817 ROCK MERRITT AVENUE
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-1800
Practice Address - Country:US
Practice Address - Phone:910-907-8481
Practice Address - Fax:910-844-3290
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008181207RH0003X, 364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology