Provider Demographics
NPI:1568977908
Name:KANTERS, KELSEY JOANN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:JOANN
Last Name:KANTERS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CANDLER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6093
Mailing Address - Country:US
Mailing Address - Phone:912-352-1700
Mailing Address - Fax:912-354-8545
Practice Address - Street 1:225 CANDLER DR STE 100
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405
Practice Address - Country:US
Practice Address - Phone:912-352-1700
Practice Address - Fax:912-354-8545
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN272910363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily