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Individual
KELSEY D ALLGOOD
Active
Individual
KELSEY D ALLGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002808A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001342723
ANTHEM PTAN
IN
01
—
1102422942
ANTHEM PTAN
IN
05
—
300033749
—
IN
01
—
Q00403937
RAILROAD PTAN
IN
Enumeration date
11/10/2019
Last updated
05/07/2025
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