Individual
KELLY MICHAEL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1001 S GEORGE ST, YORK, PA 17403-3676
(717) 812-7687
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN590370
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN590370
PA
Other
Enumeration date
06/02/2014
Last updated
03/30/2026
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