Individual
LISA L KELLY
Active
Individual
LISA L KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP015590
PA
363LW0102X
Women's Health Nurse Practitioner
Primary
SP015590
PA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
SP015590
PA
367A00000X
Advanced Practice Midwife
—
—
Other
Enumeration date
12/10/2013
Last updated
09/06/2016
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