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Individual
MS. PATRICIA A KELLY
Active
Individual
MS. PATRICIA A KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NMD, FNP-BC, GNPC-BC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP04543
OH
363LF0000X
Family Nurse Practitioner
71000324A
IN
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.04543
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000577056
ANTHEM
OH
05
—
2271741
—
OH
01
—
421534506126
CARESOURCE
OH
Enumeration date
08/15/2006
Last updated
01/10/2018
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