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Individual
KELLY KAZLO
Active
Individual
KELLY KAZLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
R126942
MD
363L00000X
Nurse Practitioner
R126942
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R126942
MD
Other
Enumeration date
08/05/2006
Last updated
06/27/2019
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