Individual
LATRECA MARIE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMA/CNA
Contact information
Practice address
4438 E FALCON ST, WICHITA, KS 67220-1776
(316) 347-6633
Mailing address
PO BOX 20803, WICHITA, KS 67208-6803
(316) 347-6633
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
KS
376K00000X
Nurse's Aide
Primary
05352
KS
Other
Enumeration date
02/15/2013
Last updated
02/15/2013
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