Individual
CHRISTINA J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
19601 W 101ST ST, LENEXA, KS 66219
(913) 780-0497
Mailing address
19601 W 101ST ST, LENEXA, KS 66219
(913) 780-0497
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01095
KS
Other
Enumeration date
12/12/2008
Last updated
12/12/2008
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