Provider Demographics
NPI:1437045853
Name:STAUFFER, KELSIE (PMHNP)
Entity type:Individual
Prefix:
First Name:KELSIE
Middle Name:
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:KELSIE
Other - Middle Name:
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:PIERCE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65723-2100
Mailing Address - Country:US
Mailing Address - Phone:417-476-1000
Mailing Address - Fax:417-943-5693
Practice Address - Street 1:411 3RD ST
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-2008
Practice Address - Country:US
Practice Address - Phone:417-476-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025022096363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health