Individual
MS. KELLY C ACEVEDO
Active
Individual
MS. KELLY C ACEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, GNP
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
2854
SC
363LG0600X
Gerontology Nurse Practitioner
Primary
249757
NC
363LG0600X
Gerontology Nurse Practitioner
2854
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7005508
—
NC
05
—
NP1093
—
SC
01
—
P00813613
RAILROAD MEDICARE ID-RSFPN
SC
Enumeration date
03/08/2007
Last updated
06/18/2013
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