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Individual

MS. PATRICIA JO KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.R.N.P.

Contact information

Practice address
6701 N CHARLES ST, DEPT OF SURGERY, BALTIMORE, MD 21204-6808
(443) 849-2670
Mailing address
PO BOX 631568, BALTIMORE, MD 21263-1568

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R053758
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
265571
GBMC KAISER PERM
MD
01
KJ60/89218901
CAREFIRST MARYLAND GBMC
MD
01
S1250009
CAREFIRST REGIONAL GBMC
MD
Enumeration date
11/17/2006
Last updated
08/01/2007
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