Provider Demographics
NPI:1881944817
Name:HUMMEL, KELSI (PA-C)
Entity type:Individual
Prefix:
First Name:KELSI
Middle Name:
Last Name:HUMMEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-1925
Mailing Address - Country:US
Mailing Address - Phone:570-765-3875
Mailing Address - Fax:
Practice Address - Street 1:761 5TH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4210
Practice Address - Country:US
Practice Address - Phone:717-261-2583
Practice Address - Fax:717-261-2584
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055760363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical