# MRS. KAY BOWIE KELLY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1881707453
- **Gender:** F
- **Credential:** NURSE PRACTITIONER

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | 43007 | WV | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 08/05/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001722602 | BLUE CROSS | — |
| 05 | — | 7101028000 | — | WV |
| 01 | — | P01268331 | RAILROAD | WV |
| 01 | — | WV3681D142 | MEDICARE PTAN | WV |