Individual
KELSEY ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
135 MIDWAY DR STE B, DU BOIS, PA 15801-3857
(814) 371-2348
Mailing address
135 MIDWAY DR STE B, DU BOIS, PA 15801-3857
(814) 371-2348
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA003814
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031828770
—
PA
Enumeration date
07/20/2016
Last updated
02/13/2020
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