Provider Demographics
NPI:1952031247
Name:COLLINS, KELSEY NICOLE (DNP, CRNA, APRN)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:NICOLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DNP, CRNA, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8831 MOORE RD
Mailing Address - Street 2:
Mailing Address - City:WEST PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42086-9222
Mailing Address - Country:US
Mailing Address - Phone:270-994-8196
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-3403
Practice Address - Country:US
Practice Address - Phone:859-301-2000
Practice Address - Fax:859-341-7867
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017905367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered