Individual
KELLY MARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
207 S 1ST ST APT 3A, BROOKLYN, NY 11211-4366
(314) 378-0274
Mailing address
207 S 1ST ST APT 3A, BROOKLYN, NY 11211-4366
(314) 378-0274
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F383505-01
NY
Other
Enumeration date
12/20/2022
Last updated
12/20/2022
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