Provider Demographics
NPI:1871271767
Name:KELSEY FURR LLC
Entity type:Organization
Organization Name:KELSEY FURR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FURR
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:916-365-7118
Mailing Address - Street 1:981 W CORAL CHARM WAY
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-6706
Mailing Address - Country:US
Mailing Address - Phone:916-365-7118
Mailing Address - Fax:
Practice Address - Street 1:981 W CORAL CHARM WAY
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-6706
Practice Address - Country:US
Practice Address - Phone:916-365-7118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty