Individual
BERNADETTE ANN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
251 TURNPIKE DR., FOLSOM, CA 95630
(916) 989-5930
Mailing address
251 TURNPIKE DR., FOLSOM, CA 95630
(916) 989-5930
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
207Q00000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A055070
—
CA
01
—
A055070
MED. LICENSE
CA
Enumeration date
12/13/2005
Last updated
04/14/2011
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