Individual
KELLY MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
488 SAINT LUKES DR, MONTGOMERY, AL 36117-7104
(334) 288-7808
(334) 288-8089
Mailing address
448 SAINT LUKES DR, MONTGOMERY, AL 36117-7104
(334) 288-7808
(334) 288-8089
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1-106341
AL
363LF0000X
Family Nurse Practitioner
Primary
1-106341
AL
Other
Enumeration date
07/07/2017
Last updated
12/17/2019
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