Provider Demographics
NPI:1851855241
Name:SKILJAN, KELSEY (PA)
Entity Type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:
Last Name:SKILJAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:REA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2501 N GLEBE RD STE 303
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3558
Mailing Address - Country:US
Mailing Address - Phone:703-841-1290
Mailing Address - Fax:703-841-1315
Practice Address - Street 1:2501 N GLEBE RD STE 303
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-3558
Practice Address - Country:US
Practice Address - Phone:703-841-1290
Practice Address - Fax:703-841-1315
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA363AM0700X
VA0110006547363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical