Individual
MRS. KELLY AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3034
(919) 784-1471
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 882-0795
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
247428
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
113401
NC
Other
Enumeration date
07/18/2016
Last updated
11/22/2016
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