Individual
CHRISTY KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
205 EAST HURON ST., IRVINGTON, IL 62848
(618) 249-6203
(618) 249-6263
Mailing address
19841 N IRIS LN, MOUNT VERNON, IL 62864-8832
(618) 315-0153
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209009607
IL
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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