| Kelsey House, Aprn Llc | |
|
3065 Town Ter North Port FL 34286-4363 | |
| (239) 989-7375 | |
| (239) 215-1143 |
| Full Name | Kelsey House, Aprn Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3065 Town Ter, North Port, Florida |
| Authorized Official Name and Position | Kelsey Lynne House (OWNER) |
| Authorized Official Contact | 2399898737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelsey House, Aprn Llc 3065 Town Ter North Port FL 34286-4363 Ph: (239) 989-7375 | Kelsey House, Aprn Llc 3065 Town Ter North Port FL 34286-4363 Ph: (239) 989-7375 |
| NPI Number | 1851086243 |
|---|---|
| Provider Enumeration Date | 04/10/2023 |
| Last Update Date | 10/22/2024 |
| Medicare PECOS PAC ID | 8527425826 |
|---|---|
| Medicare Enrollment ID | O20230601000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851086243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Kelsey L House |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164815676 PECOS PAC ID: 7517273436 Enrollment ID: I20150908001996 |
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