Individual
KELSEY STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
402 N TEJON ST, COLORADO SPRINGS, CO 80903-1142
(719) 633-3850
Mailing address
402 N TEJON ST, COLORADO SPRINGS, CO 80903-1142
(719) 633-3850
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0004737
CO
Other
Enumeration date
08/04/2016
Last updated
04/24/2019
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