# LISA KELLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1447237516
- **Gender:** F
- **Credential:** C.N.M.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367A00000X | Advanced Practice Midwife | 101-0014084 | VT | Yes |

## Other

- **Enumeration date:** 12/29/2005
- **Last updated:** 08/13/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00059280 | BCBS | VT |
| 05 | — | 1009149 | — | VT |
| 01 | — | 361683 | MVP | VT |
| 01 | — | 5207602 | VERMONT MANAGED CARE | VT |