Individual
TAMARA JO KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3418 MAYAPPLE LN APT 11, JACKSON, MI 49201-7286
(517) 240-9399
Mailing address
141 FIRST STREET, COLDWATER, MI 49036
(517) 278-6942
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704220283
MI
363L00000X
Nurse Practitioner
Primary
4704220283
MI
Other
Enumeration date
09/13/2011
Last updated
01/23/2020
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