Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelsi Marie Hendrickson

Individual provider Registered Nurse · NPI 1043088792

Kelsi Marie Hendrickson is a Nurse Practitioner in Corbin, Kentucky. Qualified in 2023, 3 years ago. Practices with Southeastern Emergency Physicians LLC, a 786-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
3
Licensed in
KY
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

1 Trillium Way
Corbin, KY 40701-8426
Phone: (606) 528-1212
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 4015202 (KY)
Registered Nurse Taxonomy 163W00000X · Licence 1162589 (KY)

Record details

NPI number1043088792
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 12, 2023
Last updated in NPPESJanuary 16, 2024
Certification dateJanuary 16, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Southeastern Emergency Physicians Llc — 786 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Corbin