Individual
LISA MARIE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
10 E FRONT ST APT B, MONROE, MI 48161-2269
(734) 497-9041
Mailing address
10 E FRONT ST APT B, MONROE, MI 48161-2269
(734) 497-9041
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704176148
MI
363L00000X
Nurse Practitioner
Primary
9402875
FL
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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