Provider Demographics
NPI:1164193900
Name:DENHOFF, KELSEY LYNN
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:LYNN
Last Name:DENHOFF
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 1:301 MEDICAL PARK DR STE 202B
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-3059
Mailing Address - Country:US
Mailing Address - Phone:704-381-2626
Mailing Address - Fax:
Practice Address - Street 1:301 MEDICAL PARK DR STE 202B
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-3059
Practice Address - Country:US
Practice Address - Phone:704-381-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC50168242080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics