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Individual
MR. CHARLES LEE KELLY JR.
Active
Individual
MR. CHARLES LEE KELLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
234042
TN
163WX0002X
High-Risk Obstetric Registered Nurse
Primary
234042
TN
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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