Individual
KELLEY OSBORNE MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1016 S SOUTH ST, MOUNT AIRY, NC 27030-5330
(336) 783-8900
(336) 783-3417
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5009620
NC
363LF0000X
Family Nurse Practitioner
5009620
NC
Other
Enumeration date
06/27/2017
Last updated
06/02/2025
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