Provider Demographics
NPI:1891008504
Name:WOOLSEY, KELLY D (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:D
Last Name:WOOLSEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:D
Other - Last Name:BRUCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:300 JEFFORDS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3810
Mailing Address - Country:US
Mailing Address - Phone:727-441-1524
Mailing Address - Fax:727-443-4206
Practice Address - Street 1:300 JEFFORDS ST
Practice Address - Street 2:SUITE B
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3810
Practice Address - Country:US
Practice Address - Phone:727-441-1524
Practice Address - Fax:727-443-4206
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9228188367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered