Individual
DEBRA A KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6701 N CHARLES ST, TOWSON, MD 21204-6808
(443) 849-2202
Mailing address
110 WEST RD, SUITE 210, TOWSON, MD 21204-2316
(410) 296-4616
(410) 337-5068
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R163023
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09PX
CAREFIRST BLUE SHIELD
MD
05
—
403763400
—
MD
Enumeration date
07/11/2006
Last updated
10/19/2010
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