Provider Demographics
NPI:1366078818
Name:KAMINSKA, KELSIE LEIGH
Entity type:Individual
Prefix:
First Name:KELSIE
Middle Name:LEIGH
Last Name:KAMINSKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5906 AMBROSE CIR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-4405
Mailing Address - Country:US
Mailing Address - Phone:254-535-9696
Mailing Address - Fax:
Practice Address - Street 1:5906 AMBROSE CIR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-4405
Practice Address - Country:US
Practice Address - Phone:254-535-9696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX352226164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse