Individual
BRIAN ISMAEL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
525 W ACACIA ST, STOCKTON, CA 95203-2405
(209) 944-5550
Mailing address
6701 SHOREWOOD LN, STOCKTON, CA 95219-7004
(925) 300-5917
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
95184031
CA
363L00000X
Nurse Practitioner
Primary
95184031
CA
Other
Enumeration date
05/27/2025
Last updated
07/26/2025
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