Provider Demographics
NPI:1184313082
Name:MCCAULEY, KELSEY LYNN (CDA)
Entity type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:LYNN
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:CDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5456 RENO CORPORATE DR.
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511
Mailing Address - Country:US
Mailing Address - Phone:775-636-0261
Mailing Address - Fax:775-470-5465
Practice Address - Street 1:5456 RENO CORPORATE DR.
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511
Practice Address - Country:US
Practice Address - Phone:775-825-0285
Practice Address - Fax:775-470-5465
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant