Provider Demographics
NPI:1295287480
Name:KERNS, KELSEY LYNN (DPT)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:LYNN
Last Name:KERNS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:LYNN
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:909 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:IA
Mailing Address - Zip Code:50674-1203
Mailing Address - Country:US
Mailing Address - Phone:563-578-2139
Mailing Address - Fax:563-578-2175
Practice Address - Street 1:909 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:IA
Practice Address - Zip Code:50674-1203
Practice Address - Country:US
Practice Address - Phone:563-578-2139
Practice Address - Fax:563-578-2175
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist