1700400603 NPI number — DR. KELSEY ANNE ATKINSON MD

Table of content: DR. KELSEY ANNE ATKINSON MD (NPI 1700400603)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700400603 NPI number — DR. KELSEY ANNE ATKINSON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ATKINSON
Provider First Name:
KELSEY
Provider Middle Name:
ANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FAUST
Provider Other First Name:
KELSEY
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700400603
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 980257
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23298-0257
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-828-9783
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VCUHS DEPT OF NEUROSURGERY RESIDENCY, 980631
Provider Second Line Business Practice Location Address:
1250 E. MARSHALL STREET
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23298-0631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-828-9165
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/05/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  0116034582 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)