Individual
MR. JOSEPH ANTHONY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
NAVAL HOSPITAL JACKSONVILLE, 2080 CHILD ST, JACKSONVILLE, FL 32214-0001
(904) 542-7856
(904) 542-9114
Mailing address
1706 EAGLE WATCH DR, ORANGE PARK, FL 32003-8637
(904) 215-8068
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN282245L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30800005-00
—
FL
05
—
833855377A
—
GA
05
—
833855377B
—
GA
05
—
833855377C
—
GA
Enumeration date
02/15/2006
Last updated
03/20/2015
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