Individual
JACQUELINE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1309 W 17TH ST STE 101, SIOUX FALLS, SD 57104-8805
(605) 328-8000
(605) 328-8001
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R035299
SD
Other
Enumeration date
06/12/2014
Last updated
07/01/2019
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