Individual
KELSEY E. DEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1823 COLLEGE AVE, MANHATTAN, KS 66502-3381
(785) 776-3322
Mailing address
1823 COLLEGE AVE, MANHATTAN, KS 66502
(785) 776-3322
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01475
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002134
MEDICARE PTRAN
KS
05
—
200738910C
—
KS
Enumeration date
08/08/2011
Last updated
12/15/2017
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