Individual
MARY LOU KELSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP CNM RN
Contact information
Practice address
4136 BARTLETT ST, HOMER MEDICAL CLINIC, HOMER, AK 99603
(907) 235-8586
(907) 235-6639
Mailing address
4136 BARTLETT ST, HOMER MEDICAL CLINIC, HOMER, AK 99603
(907) 235-8586
(907) 235-6639
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN8404
AK
367A00000X
Advanced Practice Midwife
Primary
NP47
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MK0010164
USDA
—
05
—
NM0188
—
AK
Enumeration date
06/15/2006
Last updated
08/20/2009
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