Provider Demographics
NPI:1649851577
Name:PRICE, KELSEA R (LPN)
Entity type:Individual
Prefix:
First Name:KELSEA
Middle Name:R
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 WINDSOR ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-4723
Mailing Address - Country:US
Mailing Address - Phone:316-519-2118
Mailing Address - Fax:
Practice Address - Street 1:5500 E KELLOGG DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1607
Practice Address - Country:US
Practice Address - Phone:316-685-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2023-12-20
Deactivation Date:2021-05-14
Deactivation Code:
Reactivation Date:2023-12-20
Provider Licenses
StateLicense IDTaxonomies
KS51999164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse