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Individual
ELIZABETH KELLY
Active
Individual
ELIZABETH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2007-00462
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146FA
BCBS
NC
05
—
1609957174
—
VA
01
—
202033
MEDCOST
NC
05
—
5906823
—
NC
01
—
810632
PARTNERS
NC
01
—
9539075
AETNA
—
Enumeration date
10/18/2006
Last updated
08/20/2010
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