Individual
KELLY JAE STRALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
140 FOX RD, VAN WERT, OH 45891-2475
(419) 232-5279
Mailing address
140 FOX RD, VAN WERT, OH 45891-2475
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.334650
OH
363LF0000X
Family Nurse Practitioner
COA14689NP
OH
363LX0106X
Occupational Health Nurse Practitioner
Primary
COA14689-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0090042
—
OH
Enumeration date
06/05/2013
Last updated
03/14/2017
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