Kelsey, Mary Lou

Kelsey, Mary Lou is an individual health care provider with primary practice located at 4136 Bartlett St Homer Medical Clinic, Homer AK 99603. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Kelsey, Mary Lou can be contacted via phone (907) 235-8586.

Contact Information

Primary practice address
4136 Bartlett St Homer Medical Clinic Homer AK 99603
Phone: (907) 235-8586
Fax: (907) 235-6639
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN8404 Alaska
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X NP47 Alaska

Profile Details

NPI number 1184668063
LBN Legal business name Kelsey, Mary Lou
Credentials ANP CNM RN
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Aug 20th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184668063 NPPES
Other MK0010164 USDA
MEDICAID NM0188 USDA

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