Provider Demographics
NPI:1942996046
Name:WINNETT, KELSEY (DC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:WINNETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 NE 41ST ST UNIT 111
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-6014
Mailing Address - Country:US
Mailing Address - Phone:712-779-0659
Mailing Address - Fax:
Practice Address - Street 1:1605 SE DELAWARE AVE STE D
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-4595
Practice Address - Country:US
Practice Address - Phone:515-777-1104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA119276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor