Individual
HEATHER C KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0816
(434) 924-2283
(434) 982-0019
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101233706
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5721296
—
VA
Enumeration date
11/07/2006
Last updated
07/31/2021
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