Provider Demographics
NPI:1366287468
Name:TOMEK, KELSEY (RN)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:
Last Name:TOMEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:KEMPF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:80 S VIEW DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20639-2529
Mailing Address - Country:US
Mailing Address - Phone:843-385-0228
Mailing Address - Fax:
Practice Address - Street 1:655 W LOMBARD ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1512
Practice Address - Country:US
Practice Address - Phone:410-706-0501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR209496163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse