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Individual
MS. SANDRA K KELLEY
Active
Individual
MS. SANDRA K KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1-081115
AL
363LF0000X
Family Nurse Practitioner
Primary
RN067940
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-30502
BLUE CROSS OF AL PROV #
AL
05
—
891010421
—
AL
Enumeration date
04/26/2006
Last updated
12/13/2013
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