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Individual

DR. ANGELA MASTRACCHIO KELLY-SHELBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP/FNP-C

Contact information

Practice address
627 QUINBY WAY, THE VILLAGES, FL 32162-8698
(352) 391-4818
Mailing address
627 QUINBY WAY, THE VILLAGES, FL 32162-8698
(352) 391-4818

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
FL ARNP # 2202962
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3023141-00
FL
01
500022154
RR MEDICARE GROUP
FL
01
590634434-008
HUMANA-MILITARY
FL
01
7555531
PRO-AMERICA-BCE EMERGIS
FL
Enumeration date
01/15/2014
Last updated
01/15/2014
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