Individual
MR. MARION RANDY KELLY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
10344 PARK RD STE 300, CHARLOTTE, NC 28210-8505
(704) 228-6994
Mailing address
10344 PARK RD STE 300, CHARLOTTE, NC 28210-8505
(704) 477-2565
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2023064441
NC
Other
Enumeration date
11/02/2023
Last updated
12/17/2025
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