Provider Demographics
NPI:1508627407
Name:YARBER, KELSEY AMELIA
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:AMELIA
Last Name:YARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2919
Mailing Address - Country:US
Mailing Address - Phone:508-963-4405
Mailing Address - Fax:
Practice Address - Street 1:204 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213-2919
Practice Address - Country:US
Practice Address - Phone:508-963-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-189194163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse