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Individual
KELSEY CHARLOTTE O'MARA
Active
Individual
KELSEY CHARLOTTE O'MARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10001499A
IN
363A00000X
Physician Assistant
Primary
PA1333
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001202435
ANTHEM PIN
—
05
—
0314133
—
OH
01
—
12060975
CAQH PROVIDER ID
—
01
—
1700235
WELLCARE OF KY PROVIDER ID NUMBER
KY
05
—
300018062
—
IN
05
—
7100155270
—
KY
01
—
98745KYIP
AETNA BETTER HEALTH
—
01
—
CS1828800128
CARESOURCE ID
—
Enumeration date
12/01/2009
Last updated
09/11/2026
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