Individual
MRS. CRYSTAL SUE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4881 SUGAR MAPLE DR, DAYTON, OH 45433-5529
(937) 522-2813
(937) 656-1265
Mailing address
4881 SUGAR MAPLE DR, DAYTON, OH 45433-5529
(937) 522-2813
(937) 656-1265
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
RN254302
OH
251B00000X
Case Management Agency
RN254302
OH
364SI0800X
Informatics Clinical Nurse Specialist
Primary
RN254302
OH
Other
Enumeration date
07/09/2024
Last updated
08/13/2024
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