Individual
MICHELLE A KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
600 E 1ST ST, SPRING VALLEY, IL 61362-1512
(815) 875-6001
(815) 875-3612
Mailing address
2211 TWIN OAK RD, PERU, IL 61354-1511
(815) 224-4241
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023186517
BUREAU VALLEY ANESTHESIA
IL
01
—
1134202823
NPI
IL
Enumeration date
10/24/2006
Last updated
07/08/2007
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