Individual
KELLY MARINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-5108
(319) 356-8443
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-5108
(319) 356-8443
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
118529
IA
363L00000X
Nurse Practitioner
C118529
IA
363LP0200X
Pediatric Nurse Practitioner
Primary
C118529
IA
Other
Enumeration date
02/26/2014
Last updated
03/09/2022
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