# BETH A KELLEY

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

## Provider details

- **NPI number:** 1972724821
- **Gender:** F
- **Credential:** NP, CNM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 4704194227 | MI | — |
| 363LF0000X | Family Nurse Practitioner | 4704194227 | MI | — |
| 367A00000X | Advanced Practice Midwife | 4704194227 | MI | Yes |

## Other

- **Enumeration date:** 05/01/2007
- **Last updated:** 12/06/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000612032 | BCBS | IN |
| 01 | — | 160G510560 | BCBS GROUP-WOMENS SERVICES | MI |
| 05 | — | 200932840 | — | IN |
| 01 | — | 700G560080 | BCBS GROUP-THREE RIVERS HEALTH | MI |