Provider Demographics
NPI:1790423671
Name:GUERRERO, KELSIE ELAINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KELSIE
Middle Name:ELAINE
Last Name:GUERRERO
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 1:41951 133RD ST
Mailing Address - Street 2:
Mailing Address - City:PIERPONT
Mailing Address - State:SD
Mailing Address - Zip Code:57468-5005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5000 S MINNESOTA AVE STE 100
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2700
Practice Address - Country:US
Practice Address - Phone:605-400-9975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-21
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR045908163W00000X
SDCP002447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse