Individual
KEVIN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N., CDOE
Contact information
Practice address
400 BALD HILL RD, SUITE 520, WARWICK, RI 02886-1617
(401) 793-8520
(401) 793-8527
Mailing address
1 COMMERCE ST, CENTRAL ADMINISTRATION, LINCOLN, RI 02865-1186
(401) 793-8392
(401) 793-8391
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN47992
RI
163WC0400X
Case Management Registered Nurse
RN47992
RI
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN47992
RI
Other
Enumeration date
04/22/2015
Last updated
09/30/2015
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