KELSEY RUSSO (NPI# 1467993626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467993626 |
| Entity Type | Individual |
| Full Name | KELSEY RUSSO |
| Practice Address |
2362 Tanglewood Lane Lake Ariel PA 18436 |
| Practice Telephone | 5708628842 |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2255A2300 | PA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | PA | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497182463 | Kelsey Lynne Russo | Physical Therapist | 2625 Foxpointe Drive, Columbus, IN 47203 | 2013-10-04 |
| Street Address |
2362 TANGLEWOOD LANE |
| City | LAKE ARIEL |
| State | PA |
| Zip Code | 18436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548716145 | Little Creek Out Patient Services LLC | Clinic/Center | 518 Easton Turnpike, Lake Ariel, PA 18436 | 2016-09-01 |
| 1720460454 | Erin Mattox | Physical Therapy Assistant | 1089 Mustang Road, Lake Ariel, PA 18436 | 2015-06-18 |
| 1033373485 | Katherine Rosalie Schloesser | Dentist | 554 Hamlin Highway, Lake Ariel, PA 18436 | 2008-07-15 |
| 1962676494 | Marcela Blair | Social Worker | 369 Renwood Court, Lake Ariel, PA 18436 | 2008-04-16 |
| 1407048689 | Micro Diagnostics Imaging Inc | Durable Medical Equipment & Medical Supplies | 473 Easton Turnpike, Suite G, Lake Ariel, PA 18436 | 2007-08-13 |
| 1780667097 | Robert J. Morton | Pediatrics | 62 Industrial Park Road, Lake Ariel, PA 18436 | 2005-11-22 |
| 1265414296 | Theresa A Lafranco | Pediatrics | 62 Industrial Park Rd, Lake Ariel, PA 18436 | 2005-11-16 |
| 1295268365 | Sabrina Noelle Cimerol | Student in an Organized Health Care Education/Training Program | 358 Hamlin Hwy, Suite 2, Lake Ariel, PA 18436 | 2017-04-06 |
| 1356632236 | Brian A. Barland | Pharmacist | 639 Hamlin Hwy, Lake Ariel, PA 18436 | 2011-04-26 |
| 1063726255 | Bijan Reza Ahmadzadeh | Dentist | 358 Hamlin Hwy, Suite 2, Lake Ariel, PA 18436-0000 | 2010-07-30 |
| Find all providers in zip 18436 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295268365 | Sabrina Noelle Cimerol | Student in an Organized Health Care Education/Training Program | 358 Hamlin Hwy, Suite 2, Lake Ariel, PA 18436 | 2017-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1356942825 | Aisha Ghauri | Student in an Organized Health Care Education/Training Program | 645 Springhouse Ln, Hummelstown, PA 17036-7009 | 2020-11-02 |
| 1891395828 | Roopali Mahajan | Student in an Organized Health Care Education/Training Program | 4101 Spruce St Apt 108, Philadelphia, PA 19104-4059 | 2020-10-28 |
| 1629678925 | Jonathan Welch | Student in an Organized Health Care Education/Training Program | 4200 E City Ave, Rowland Hall, Suite 207, Physician Assistant Department, Philadelphia, PA 19131 | 2020-10-27 |
| 1093313157 | Betty M Beimel | Student in an Organized Health Care Education/Training Program | 5966 Route 66, Kane, PA 16735-3434 | 2020-10-12 |
| 1104432616 | Zach Quince | Student in an Organized Health Care Education/Training Program | 370 Birch St, Imperial, PA 15126-1158 | 2020-09-20 |
| 1073129862 | Philip Andrus | Student in an Organized Health Care Education/Training Program | 3420 Forbes Ave Fl 2, Pittsburgh, PA 15213-3203 | 2020-09-17 |
| 1992310049 | Rachana Amin | Student in an Organized Health Care Education/Training Program | 12 Fitzgerald Dr, Moosic, PA 18507-2105 | 2020-09-14 |
| 1992310767 | Natasha Ann Parrish | Student in an Organized Health Care Education/Training Program | Millersville University, School of Social Work, Strayer, 37 W. Frederick Street, Millersville, PA 17551 | 2020-09-09 |
| 1205440138 | Beth Ann Wagner | Student in an Organized Health Care Education/Training Program | 1444 E Main St, Douglassville, PA 19518-9116 | 2020-09-08 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ARIEL |
| Zip Code | 18436 |
Please comment or provide details below to improve the information on KELSEY RUSSO.
| 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.