Individual
MRS. KELLY JOCELYN TAVELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1210 W SAGINAW ST, LANSING, MI 48915-1927
(517) 364-6212
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(505) 453-1060
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704294056
MI
Other
Enumeration date
05/15/2015
Last updated
10/22/2015
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