Individual
MRS. AMY SUE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2930 HOLDEN BEACH RD SW, SUPPLY, NC 28462-5702
(910) 842-5991
(910) 842-5994
Mailing address
2930 HOLDEN BEACH ROAD, SUPPLY, NC 28462-4096
(910) 842-5991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102882
NC
Other
Enumeration date
07/10/2006
Last updated
12/22/2011
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