Leroy, Kelsey Danielle

Leroy, Kelsey Danielle is an individual health care provider with primary practice located at 272 Nw Medical Loop Suite C, Roseburg OR 97471-5597. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Leroy, Kelsey Danielle can be contacted via phone (541) 440-3532.

Contact Information

Primary practice address
272 Nw Medical Loop Suite C Roseburg OR 97471-5597
Fax: (541) 440-3554
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1457615353
LBN Legal business name Leroy, Kelsey Danielle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2012
Last updated May 21st, 2015 - about 10 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 1457615353 NPPES
Oregon MEDICAID 500663439

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