Provider Demographics
NPI:1881198786
Name:HUNTOON, KELSEY ELIZABETH (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:ELIZABETH
Last Name:HUNTOON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:E
Other - Last Name:BREDIMUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:109 ALLMOND AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-4901
Mailing Address - Country:US
Mailing Address - Phone:302-530-3171
Mailing Address - Fax:
Practice Address - Street 1:4735 OGLETOWN STANTON RD STE 1250
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2076
Practice Address - Country:US
Practice Address - Phone:302-623-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0001126363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner