DR. SHANNON KELSO (NPI# 1346893914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346893914 |
| Entity Type | Individual |
| Full Name | DR. SHANNON KELSO |
| Credential | DNP, CRNP-PMH, PMHNP |
| Practice Address |
658 Kenilworth Dr Ste 206 Towson MD 21204-2334 |
| Practice Telephone | 4438417550 |
| Mailing Telephone | 4438417550 |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2019-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R207920 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407164502 | Shannon Holer Kelso | Dentist | 2156 Harden Blvd., Lakeland, FL 33803 | 2010-09-23 |
| Street Address |
658 KENILWORTH DR STE 206 |
| City | TOWSON |
| State | MD |
| Zip Code | 21204-2334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382109 | Kacie Naylor | Nurse Practitioner | 658 Kenilworth Dr Ste 206, Towson, MD 21204-2334 | 2020-10-08 |
| 1073166401 | Tarleen Weston | Registered Nurse | 658 Kenilworth Dr Ste 206, Towson, MD 21204-2334 | 2019-07-24 |
| 1649767708 | Victoria Stith, LLC | Clinic/Center | 658 Kenilworth Dr Ste 206, Towson, MD 21204-2334 | 2018-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194347575 | Sheppard Pratt Non Contracted Services, LLC | Psychiatry & Neurology | 6525 N. Charles Street, Gibson Building, Towson, MD 21204 | 2020-05-08 |
| 1578104428 | Debra James | Counselor | 6901 N. Charles Street, Towson, MD 21204 | 2019-10-02 |
| 1235696808 | Sarita Hinton | Social Worker | 300 Allegheny Ave Ste 101, Baltimore, MD 21204 | 2019-03-01 |
| 1952883159 | Peace,llc | Social Worker | 304 W. Chesapeake Ave, Towson, MD 21204 | 2018-09-04 |
| 1841772654 | Hannah Kimberly Jefferson | Acupuncturist | 7407 York Road, Towson, MD 21204 | 2018-08-29 |
| 1699255216 | Samantha Ann Rogers | Nurse Practitioner | 222 Bosley Avenue, Suite C3, Towson, MD 21204 | 2018-08-14 |
| 1750867560 | Angela Michelle Hester | Nurse Practitioner | 6525 N Charles St #085, Towson, MD 21204 | 2018-07-15 |
| 1043729098 | Communication Apptitude Inc. | Speech-Language Pathologist | 7400 York Road, Suite 231, Towson, MD 21204 | 2017-09-21 |
| 1679090203 | Brian Dougherty | Acupuncturist | 800 Kenilworth Dr, Ste# 828, Towson, MD 21204 | 2017-08-24 |
| 1659891976 | Erin Mcgovern | Specialist/Technologist | Towson Sports Medicine 8322 Bellona Ave, Suite Number 100, Baltimore, MD 21204 | 2017-06-27 |
| Find all providers in zip 21204 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699255216 | Samantha Ann Rogers | Nurse Practitioner | 222 Bosley Avenue, Suite C3, Towson, MD 21204 | 2018-08-14 |
| 1750867560 | Angela Michelle Hester | Nurse Practitioner | 6525 N Charles St #085, Towson, MD 21204 | 2018-07-15 |
| 1841789146 | Victoria Mojibola | Nurse Practitioner | 1045 Taylor Ave Ste 44d, Towson, MD 21286-8328 | 2018-05-02 |
| 1003314675 | Empowerment Healthcare Systems,llc | Nurse Practitioner | 1055 Taylor Ave Ste 216, Towson, MD 21286-8341 | 2018-01-29 |
| 1518903905 | Fishel, Watson, & Lemaire Pa | Nurse Practitioner | 110 E Pennsylvania Ave, Towson, MD 21286-5118 | 2006-06-22 |
| 1790382109 | Kacie Naylor | Nurse Practitioner | 658 Kenilworth Dr Ste 206, Towson, MD 21204-2334 | 2020-10-08 |
| 1962013425 | Grace Serafini | Nurse Practitioner | 6535 N Charles St Ste 300, Towson, MD 21204-5824 | 2020-08-10 |
| 1922621580 | Empowerment Healthcare Systems, LLC | Nurse Practitioner | 1055 Taylor Ave Ste 216, Towson, MD 21286-8341 | 2020-05-18 |
| 1932746062 | Ayorinde Oyeneyin | Nurse Practitioner | 6501 N Charles St, Towson, MD 21204-6819 | 2019-12-09 |
| 1700422177 | Ubachi Nonye Chukwuzubelu | Nurse Practitioner | 6501 N Charles St, Towson, MD 21204-6819 | 2019-11-20 |
| Find all providers in TOWSON | ||||
Please comment or provide details below to improve the information on DR. SHANNON KELSO.
| 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.