Individual
KELLY ANN WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
317 E 34TH ST, NEW YORK, NY 10016-4974
(732) 379-1237
Mailing address
72 OLD RD, SEWAREN, NJ 07077-1242
(732) 379-1237
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
26NJ01327700
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
F308267-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F308267-1
LICENSE NUMBER
NY
Enumeration date
08/23/2017
Last updated
06/19/2023
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