Individual
KELLI L MCKIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
651 COLLIERS WAY STE 401, WEIRTON, WV 26062-5054
(304) 908-4617
Mailing address
651 COLLIERS WAY STE 401, WEIRTON, WV 26062-5054
(304) 908-4617
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
115106
WV
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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