Individual
COLLEEN LORA JAIMIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2111 NEUSE BLVD STE J, NEW BERN, NC 28560-4318
(252) 636-0300
Mailing address
2111 NEUSE BLVD STE J, NEW BERN, NC 28560-4318
(252) 636-0300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08921
NC
Other
Enumeration date
07/29/2019
Last updated
12/11/2024
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