Individual
KELLY TYRRELL RANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2191 9TH AVE N, ST PETERSBURG, FL 33713-7146
(727) 821-8101
Mailing address
10516 SILHAVY DR, LARGO, FL 33774-5223
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11006219
FL
Other
Enumeration date
02/19/2020
Last updated
04/29/2020
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