KELSEY GENE BROOME


Address: 10 Missile Ave, Minot Afb, ND 58705-5003
Phone: 7017235232

KELSEY GENE BROOME (NPI# 1013253228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013253228
Entity Type Individual
Full Name KELSEY GENE BROOME
Credential PHYSICIAN ASSISTANT
Practice Address 10 Missile Ave
Minot Afb
ND 58705-5003
Mailing Address 401 Northampton Circle
Fort Walton Beach
FL 32547
Practice Telephone 7017235232
Mailing Telephone 4054105622
Enumeration Date 2012-12-14
Last Update Date 2019-12-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
Physician Assistants & Advanced Practice Nursing Providers
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care
N 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Office Location

Street Address 10 MISSILE AVE
City MINOT AFB
State ND
Zip Code 58705-5003

Providers in the same location

NPI Name Taxonomy Address Enumeration
1427031673 5th Medical Group Military/U.S. Coast Guard Pharmacy 10 Missile Ave, Minot Afb, ND 58705-5003 2005-11-22
1952936825 Dylan M Morales Military Health Care Provider 10 Missile Ave, Minot Afb, ND 58705-5003 2020-03-11
1598127862 Thomas Wagoner Pediatrics 10 Missile Ave, Minot Afb, ND 58705-5003 2016-03-24
1093142275 Aaron D Geyer Physician Assistant 10 Missile Ave, Minot Afb, ND 58705-5003 2013-10-02
1649605072 Jared Jon Solomon Psychiatry & Neurology 10 Missile Ave, Minot Afb, ND 58705 2013-09-04
1023457256 Matthew Wayne Greene Family Medicine 10 Missile Ave, Minot Afb, ND 58705-5003 2013-06-20
1033491121 Patrick Mccue Physician Assistant 10 Missile Ave, Minot Afb, ND 58705-5003 2011-09-14
1760764393 5th Medical Group Military Hospital 10 Missile Ave, Minot Afb, ND 58705-5003 2011-09-09
1366754400 Dfas-jfll/in Military Hospital 10 Missile Ave, Minot Afb, ND 58705-5003 2010-07-06
1508097247 Agnes Liem Registered Nurse 10 Missile Ave, Minot Afb, ND 58705-5003 2009-07-29
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1265093900 Coty Winn Student in an Organized Health Care Education/Training Program Minot Afb Medical Group, 194 Missile Avenue, Minot Afb, ND 58705 2019-06-24
1144717596 Angela Kennedy Social Worker 5 Mdg 194 Missile Avenue, Minot Afb, ND 58705 2018-04-20
1386064780 Desiree Avedon Aaron-barber Licensed Practical Nurse Minot Va Cboc, Minot Air Force Base, Minot, ND 58705 2014-04-24
1366771644 Melanie Renee Roserie Social Worker 194 Missile Avenue, Minot Afb - 5 Mdg Mental Health Clinic, Minot, ND 58705 2009-12-15
1255565289 Javier Alberto Padial Pediatrics 194 Missle Ave., Minot Afb, Apo, AA 58705 2009-05-05
1184694127 Michelle Joy Fundingsland Dietitian, Registered 201 Missile Ave, Minot Afb, ND 58705 2006-01-24
1306404645 Yongke Tan Pharmacist 194 Missile Avenue, Minot Afb, ND 58705 2019-06-02
1689106320 Priscilla Barrio Student in an Organized Health Care Education/Training Program 194 Missile Ave, Minot Afb, ND 58705 2017-03-31
1881953602 Casey Simon Brock Physician Assistant 194 Missile Avenue, Minot Air Force Base, ND 58705 2012-05-14
1154618973 Brian Grant Kay Social Worker 194 Missile Ave, Minot, ND 58705 2011-06-30
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1730162330 Anne Patricia Heinly Physician Assistant 10 Missle Ave, Minot Afb, ND 58705-5003 2005-11-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1891355608 Jenny L Brown Physician Assistant 3750 19th St Sw, Center, ND 58530-9700 2019-06-14
1407335383 Chelsey Galipeau Physician Assistant 516 1st Ave Sw, Dickinson, ND 58601-5906 2018-08-10
1093184657 Grant Lannoye Physician Assistant 7448 Us Hwy 281, Cando, ND 58324-0688 2015-09-24
1821408907 Laramie Jay Richmond Physician Assistant 311 Davis St N, Burlington, ND 58722-2027 2014-04-29
1962749226 Lindsey K Baker Physician Assistant 1600 2nd Ave Sw Ste 19, Minot, ND 58701-3459 2013-01-07
1205015633 Jamie M Brown Physician Assistant 1711 Gold Dr S, Suite 170, Fargo, ND 58103-6416 2007-11-02
1811036247 Tyesha Dawn Marie Dent Physician Assistant 302 North Main, Elgin, ND 58533 2007-02-05
1629160080 Teresa Nielsen Physician Assistant 820 2nd Ave W, New England, ND 58647 2006-09-29
1841208394 Lynette Marie Azure Physician Assistant 320 4th St Se, Devils Lake, ND 58301-3610 2006-08-03
1790703353 Mary Jane Kadry Physician Assistant 1121 Westrac Dr S Ste 204, Fargo, ND 58103-2385 2006-07-18
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Competitor

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City MINOT AFB
Zip Code 58705

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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