Provider Demographics
NPI:1184394397
Name:DRZEWIECKI, KELSEA (FNP-BC)
Entity type:Individual
Prefix:
First Name:KELSEA
Middle Name:
Last Name:DRZEWIECKI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KELSEA
Other - Middle Name:
Other - Last Name:BABCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1537 E HILL RD STE 400
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5190
Mailing Address - Country:US
Mailing Address - Phone:810-333-7309
Mailing Address - Fax:
Practice Address - Street 1:1537 E HILL RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-5190
Practice Address - Country:US
Practice Address - Phone:810-333-7309
Practice Address - Fax:949-561-4538
Is Sole Proprietor?:No
Enumeration Date:2021-09-18
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704314568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily