Individual
MR. LEVI A KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
315 S OSTEOPATHY AVE, KIRKSVILLE, MO 63501-6401
(660) 785-1098
(660) 665-0333
Mailing address
1007 KINGS RD, KIRKSVILLE, MO 63501-2627
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2005008072
MO
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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