Individual
MS. PATRICIA MARY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1270 KOTNUM ROAD, WARM SPRINGS, OR 97761
(541) 553-1196
Mailing address
1270 KOTNUM ROAD, WARM SPRINGS, OR 97761
(541) 553-1196
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
RN00074801
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237855
—
OR
Enumeration date
10/25/2006
Last updated
08/04/2011
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