Individual
MRS. MICHELLE ROSE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
701 W HIGH ST, JEFFERSON CITY, MO 65101-1525
(573) 636-3313
Mailing address
8205 DEER HAVEN ROAD, JEFFERSON CITY, MO 65101-8706
(573) 632-2069
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2104005310
MO
Other
Enumeration date
03/04/2014
Last updated
03/04/2014
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