Individual
JENNIFER JO KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA.08014-NP
OH
363LP0200X
Pediatric Nurse Practitioner
COA.08014-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2656951
—
OH
Enumeration date
05/05/2006
Last updated
09/30/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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