Provider Demographics
NPI:1306329917
Name:PAISLEY, KELSEY MARIE (RN)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:MARIE
Last Name:PAISLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N FRANKLIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3070
Mailing Address - Country:US
Mailing Address - Phone:608-461-1714
Mailing Address - Fax:
Practice Address - Street 1:123 SHATO LN
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-3795
Practice Address - Country:US
Practice Address - Phone:608-461-1714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI243182163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse