Provider Demographics
NPI:1962177840
Name:KERNS, KELSEE
Entity type:Individual
Prefix:
First Name:KELSEE
Middle Name:
Last Name:KERNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-1913
Mailing Address - Country:US
Mailing Address - Phone:304-788-7670
Mailing Address - Fax:
Practice Address - Street 1:45 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-1913
Practice Address - Country:US
Practice Address - Phone:304-788-7670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator