Individual
KELSEY NICOLE WRUBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5000 ESTATE ENIGHED, ST JOHN, VI 00830-6120
(340) 714-4270
(888) 979-9488
Mailing address
5000 ESTATE ENIGHED, ST JOHN, VI 00830-6120
(740) 816-5332
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
114
VI
363A00000X
Physician Assistant
7229
AZ
363AM0700X
Medical Physician Assistant
7229
AZ
363AS0400X
Surgical Physician Assistant
7229
AZ
Other
Enumeration date
09/27/2018
Last updated
03/24/2025
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