Individual
EILEEN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1403 MEDICAL PLAZA DR, SUITE 202, SANFORD, FL 32771-1000
(407) 322-3096
(407) 321-5655
Mailing address
1403 MEDICAL PLAZA DR, SUITE 202, SANFORD, FL 32771-1000
(407) 322-3096
(407) 321-5655
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP2778312
FL
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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