Individual
KELLY O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1204 W MAIN ST, 5TH FLOOR, CHARLOTTESVILLE, VA 22903-2824
(800) 362-2203
(434) 243-5204
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024173788
VA
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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