Kelsey M Stafford, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN9309076 Issued in FL

Practice address

1726 Kingsley Ave Ste 2
Orange Park, FL 32073-4411

Phone

(904) 278-5644

Fax

(904) 278-5659

NPI assigned

Oct 19, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1336459700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3292 COUNTY ROAD 220",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320684357",
            "telephone_number": "904-291-5561",
            "fax_number": "904-291-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 KINGSLEY AVE STE 2",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734411",
            "telephone_number": "904-278-5644",
            "fax_number": "904-278-5659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "KELSEY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "RN9309076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "RN9309076",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Registered Nurse in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Psychiatric/Mental Health Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.