Provider Demographics
NPI:1790459618
Name:DOBBS, KELSEY L (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:L
Last Name:DOBBS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-2838
Mailing Address - Country:US
Mailing Address - Phone:304-721-9303
Mailing Address - Fax:304-250-1756
Practice Address - Street 1:9223 BROADWAY ST STE 103
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9759
Practice Address - Country:US
Practice Address - Phone:281-412-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV110284363LF0000X
TX1124675363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily