Provider Demographics
NPI:1740029420
Name:CHILD, KELSEY MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:MARIE
Last Name:CHILD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3244 E GRAND BLANC RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8117
Mailing Address - Country:US
Mailing Address - Phone:517-526-1268
Mailing Address - Fax:
Practice Address - Street 1:728 W WACKERLY ST STE 200
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4724
Practice Address - Country:US
Practice Address - Phone:989-631-8300
Practice Address - Fax:989-839-8170
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2025-01-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant