Doctor Name: | KELSEY JANELLE-MARIE AMENT |
NPI Number: | 1417320664 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 282243 |
Business Practice Address: | 610 E Dr Martin Luther King Jr Dr Maxton, NC - 283641800 |
Business Phone Number: | 9108445253 |
Business Fax Number: | 9108443290 |
Mailing Address: | 60 Commerce Plaza Cir, PEMBROKE |
State: | NC |
Postal Code: | 283727386 |
Phone Number: | 9105212900 |
Fax Number: | 9107759165 |
NPI Enumeration Date: | 11/10/2015 |
NPI Last Update Date: | 12/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 282243 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |