Individual
KELLY BILELLO HAMMOUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1901 S HAWTHORNE RD STE 310, WINSTON SALEM, NC 27103-3915
(336) 448-2427
(336) 765-2869
Mailing address
1830 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4014
(336) 448-2427
(336) 765-2869
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
222051
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
952573016
—
NC
Enumeration date
07/04/2012
Last updated
07/21/2022
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