Provider Demographics
NPI:1962048694
Name:DOWNTON, KELSEY (APRN)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:DOWNTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21890
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4115
Mailing Address - Country:US
Mailing Address - Phone:502-907-0356
Mailing Address - Fax:502-919-9780
Practice Address - Street 1:320 THOMAS MORE PKWY STE 202
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3456
Practice Address - Country:US
Practice Address - Phone:859-331-0432
Practice Address - Fax:859-331-0956
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025539363L00000X
KY3014243363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300059895Medicaid
KY7100652020Medicaid
OH0380807Medicaid