Individual
JEANNE M. KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
3322 CHANATE RD, SANTA ROSA, CA 95404-1708
(707) 565-4876
Mailing address
3322 CHANATE RD, SANTA ROSA, CA 95404-1708
(707) 696-4094
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
320580
CA
Other
Enumeration date
11/16/2015
Last updated
11/16/2015
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