Provider Demographics
NPI:1912553595
Name:PEIFER, KELSEY LYNN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:LYNN
Last Name:PEIFER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6131 BALDRIDGE TER
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5858
Mailing Address - Country:US
Mailing Address - Phone:240-446-7867
Mailing Address - Fax:
Practice Address - Street 1:6131 BALDRIDGE TER
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5858
Practice Address - Country:US
Practice Address - Phone:240-446-7867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-10
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR200974363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics