Provider Demographics
NPI:1134951726
Name:EARLINGTON, KELSEY JACQUELINE (PA)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:JACQUELINE
Last Name:EARLINGTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 E. BETTERAVIA RD., SUITE 201
Mailing Address - Street 2:A.T. STILL UNIVERSITY - COLLEGE FOR HEALTHY COMMUNITIES
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1075 E. BETTERAVIA RD., SUITE 201
Practice Address - Street 2:A.T. STILL UNIVERSITY - COLLEGE FOR HEALTHY COMMUNITIES
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454
Practice Address - Country:US
Practice Address - Phone:805-621-7714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical