Individual
KELLY L MEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
113 ELM ST STE 304, ENFIELD, CT 06082
(860) 741-2225
(860) 741-2229
Mailing address
113 ELM ST STE 304, ENFIELD, CT 06082-3739
(860) 741-2225
(860) 741-2229
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
00332
CT
363AM0700X
Medical Physician Assistant
Primary
00332
CT
Other
Enumeration date
11/17/2006
Last updated
08/10/2021
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