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Individual
CHRISTINA MARIE KELLEY
Active
Individual
CHRISTINA MARIE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28156791A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71004498A
IN
364SG0600X
Gerontology Clinical Nurse Specialist
71004498B
IN
Other
Enumeration date
04/16/2013
Last updated
03/05/2021
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