Individual
MOLLY KELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-4171
(336) 716-8759
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-0238
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5018301
NC
363LF0000X
Family Nurse Practitioner
F06230268
NC
Other
Enumeration date
06/13/2023
Last updated
09/05/2023
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