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Individual

MRS. DANIELLE RENEE KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RNC, IBCLC

Contact information

Practice address
205 BERGEN TPKE, 1-K, RIDGEFIELD PARK, NJ 07660-2336
(201) 658-0711
Mailing address
205 BERGEN TPKE, 1-K, RIDGEFIELD PARK, NJ 07660-2336
(201) 658-0711

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NO12428200
NJ
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-68064
NJ

Other

Enumeration date
01/21/2016
Last updated
01/21/2016
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