Provider Demographics
NPI:1922731470
Name:KELBAUGH, DAVID N JR (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:KELBAUGH
Suffix:JR
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7426 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2306
Mailing Address - Country:US
Mailing Address - Phone:520-771-0555
Mailing Address - Fax:262-260-9109
Practice Address - Street 1:699 WALNUT ST STE 400
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3962
Practice Address - Country:US
Practice Address - Phone:515-416-8830
Practice Address - Fax:262-260-9109
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTEMP276517163W00000X
IAG170194363LP0808X
WAAP61337914363LP0808X
NV847938363LP0808X, 163W00000X
AZ276517363LP0808X, 163W00000X
IA169476163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse