Provider Demographics
NPI:1740849900
Name:KAISER, KELSEY NICOLE (FNP-C)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:NICOLE
Last Name:KAISER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 DASHA LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3593
Mailing Address - Country:US
Mailing Address - Phone:954-232-3396
Mailing Address - Fax:
Practice Address - Street 1:2911 ROBERTS AVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32310-5007
Practice Address - Country:US
Practice Address - Phone:850-644-1543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily