Individual
LESLIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
333 LONG HILL RD, GROTON, CT 06340-3823
(860) 446-8858
(860) 405-2140
Mailing address
635 MAIN ST, ATTN CREDENTIALING DEPARTMENT, MIDDLETOWN, CT 06457-2718
(860) 347-6971
(860) 638-6601
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
E48644
CT
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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