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Individual
SUSAN R KELLY
Active
Individual
SUSAN R KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN048042-23
NH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN048-042-21
NH
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
048042-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40V001351NH01
ANTHEM
NH
Enumeration date
10/05/2005
Last updated
11/25/2024
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