Provider Demographics
NPI:1538499421
Name:CAMERON, KELSEY MARIE (MMSC)
Entity Type:Individual
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First Name:KELSEY
Middle Name:MARIE
Last Name:CAMERON
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Gender:F
Credentials:MMSC
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Mailing Address - Street 1:15 YORK ST
Mailing Address - Street 2:LCI 100
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3221
Mailing Address - Country:US
Mailing Address - Phone:203-737-5699
Mailing Address - Fax:203-737-1666
Practice Address - Street 1:15 YORK ST
Practice Address - Street 2:LCI 100
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3221
Practice Address - Country:US
Practice Address - Phone:203-785-4931
Practice Address - Fax:203-737-2163
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2017-03-27
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical