Individual
AMY JO KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 MICHIGAN ST NE # MC020, GRAND RAPIDS, MI 49503-2560
(616) 391-2160
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704246088
MI
Other
Enumeration date
03/15/2010
Last updated
04/22/2021
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