Individual
THERESA KELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2538 SE CHARLESTON DR, PORT ST LUCIE, FL 34952-7325
(772) 380-9377
Mailing address
2538 SE CHARLESTON DR, PORT ST LUCIE, FL 34952-7325
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN3068642
FL
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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