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Individual
MRS. MELISSA MARIE KELLY
Active
Individual
MRS. MELISSA MARIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08075
NC
363AM0700X
Medical Physician Assistant
0010-08075
NC
363AM0700X
Medical Physician Assistant
019004
NY
363AM0700X
Medical Physician Assistant
2965
SC
Other
Enumeration date
07/06/2015
Last updated
10/15/2021
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