Provider Demographics
NPI:1710278486
Name:HARVEY, KELSEY LEE (DPM)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:LEE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:LEE
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1500 DELHI ST STE 2200
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6359
Mailing Address - Country:US
Mailing Address - Phone:563-557-5930
Mailing Address - Fax:563-557-5936
Practice Address - Street 1:1500 DELHI ST STE 2200
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6359
Practice Address - Country:US
Practice Address - Phone:563-557-5930
Practice Address - Fax:563-557-5936
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000845213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1710278486Medicaid
IA1710278486OtherUNITED HEALTHCARE
IA208610002Medicare PIN