Kelsey Janelle Brannan, M.S., ATC
Individual provider Active NPI Athletic Trainer · Peru, IL
NPI 1275075590 · NPPES record last updated Nov 17, 2016
Key facts
- NPI
- 1275075590
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 096.003670 (IL)
- Practice address
- 1627 4TH St
Peru, IL 61354-3507 - Phone
- (815) 223-4479
- Fax
- (815) 223-4489
- NPI assigned
- Nov 17, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.003670 | IL | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City Center Rehabilitation West - Inc. | Past |
Accepting new patients | |
| City Center Physical Therapy - Peru, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.003670 | IL | Yes |
Addresses
Primary practice location
1627 4TH St
Peru, IL 61354-3507
Mailing address
1627 4TH St
Peru, IL 61354-3507
Phone (815) 223-4479
Other providers in Peru, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.