Laura L Kelsey, RN, BSN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

250884 Issued in TN

Practice address

65 Bugger Hollow Rd
Fayetteville, TN 37334-6863

Phone

(320) 703-8214

NPI assigned

Aug 9, 2024

Last updated

Aug 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1053142398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 BUGGER HOLLOW RD",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373346863",
            "telephone_number": "320-703-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BUGGER HOLLOW RD",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373346863",
            "telephone_number": "320-703-8214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1621 W Carroll Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606122501",
            "country_code": "US",
            "telephone_number": "888-510-0059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "RN, BSN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "TN",
            "license": "250884",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TN",
            "license": "250884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBCLC",
            "identifier": "L-313960",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edna Darlene Jenkins, BA
• Amanda Nicole Johnson, RPH
• Baylee Johnson, FNP
• Heather Ogle Johnson, MEDCCCSLP
• William R Jones, MD
• Sarah Nichole Kervin, APRN, AGACNP-BC
• Charles Alexander Kidd, MD
• Carrington Bain Kite
• Michael W Knight, CRNA
• Jinson Eugene Knott

• Lactation Consultant (Registered Nurse) in Fayetteville, TN
• Providers in Fayetteville, TN by specialty
• Lactation Consultant (Registered Nurse) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.