KELSEY WALLACE (NPI# 1063870418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063870418 |
| Entity Type | Individual |
| Full Name | KELSEY WALLACE |
| Credential | LMT |
| Practice Address |
437 Fern Ave #d Jackson MI 49202-3970 |
| Practice Telephone | 3139521233 |
| Mailing Telephone | 3139521233 |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2016-02-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 7501007544 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285199083 | Kelsey Ann Wallace | Specialist/Technologist | 3362 Fox Creek Ln, Sharpsville, PA 16150-9330 | 2019-02-05 |
| 1508098914 | Kelsey Wallace | Pharmacist | 522 Nw 24th Cir, Camas, WA 98607 | 2009-08-18 |
| 1013576990 | Kelsey A Wallace | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2019-06-13 |
| 1023328051 | Kelsey Marie Wallace | Counselor | 3115 Douglas Ave, Des Moines, IA 50310-5307 | 2010-10-08 |
| Street Address |
437 FERN AVE #D |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-3970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275154338 | Crystal Edwards | Massage Therapist | 2718 Medgar Evers Blvd, Jackson, MS 39213-7257 | 2020-04-30 |
| 1568093367 | Choice Chiropractic Pllc | Massage Therapist | 3343 Spring Arbor Rd Ste 300, Jackson, MI 49203-8623 | 2020-01-30 |
| 1821631474 | Sherry J Miller | Massage Therapist | 18 Brentshire Sq Ste A, Jackson, TN 38305-2203 | 2019-10-25 |
| 1881236479 | Donna Summers | Massage Therapist | 761 Woodlake Dr, Jackson, MS 39206-2219 | 2019-10-15 |
| 1689221574 | Tanya Karr | Massage Therapist | 847 N Highway 49-88 Ste 4, Jackson, CA 95642-2013 | 2019-08-24 |
| 1285295881 | Melissa Tittler | Massage Therapist | 119 Kenneth St, Jackson, MI 49203-1083 | 2019-06-25 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1619407046 | Edwind Allen Holsey | Massage Therapist | 908 Union St, Jackson, MI 49203-2897 | 2017-06-18 |
| 1558812214 | Derry Petty | Massage Therapist | 337 Oak Grove Ave Apt I, Jackson, MI 49203-1394 | 2016-10-18 |
| 1194171728 | Angelina Bey | Massage Therapist | 1296 N Highland Ave, Ste 6, Jackson, TN 38301-4085 | 2016-05-12 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.