Individual
MELISSA ILENE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3614 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7573
(208) 552-7700
(208) 552-1786
Mailing address
3614 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7573
(208) 552-7700
(208) 552-1786
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1668A
ID
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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