Provider Demographics
NPI:1851862221
Name:LOWE, KELSI B (NP)
Entity Type:Individual
Prefix:
First Name:KELSI
Middle Name:B
Last Name:LOWE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KELSI
Other - Middle Name:E
Other - Last Name:BAUGHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:17452 RICHMOND ROAD
Practice Address - Street 2:
Practice Address - City:CALLAO
Practice Address - State:VA
Practice Address - Zip Code:22435-2420
Practice Address - Country:US
Practice Address - Phone:804-529-6141
Practice Address - Fax:804-529-6919
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176516363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics