Individual
KELLY WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(215) 316-5151
Mailing address
2443 WHITBY RD, HAVERTOWN, PA 19083-1508
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN672355
PA
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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