# MRS. KELSEY BRIANNA SUPPA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1053700815
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2082S0105X | Surgery of the Hand (Plastic Surgery) Physician | C0005671 | MD | — |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 01/16/2015
- **Last updated:** 11/06/2023