Provider Demographics
NPI:1902028384
Name:GODSEY, KELLY K (ACNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:K
Last Name:GODSEY
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 ROCK CHIMNEY LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-7226
Mailing Address - Country:US
Mailing Address - Phone:434-243-9751
Mailing Address - Fax:434-924-2359
Practice Address - Street 1:UVA CARDIOPULMONARY TRANSPLANT
Practice Address - Street 2:BOX 800191
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0191
Practice Address - Country:US
Practice Address - Phone:434-243-9751
Practice Address - Fax:434-924-2359
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166256363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care