Individual
MR. BRIAN M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP
Contact information
Practice address
1525 W 2100 S, SALT LAKE CITY, UT 84119-1401
(801) 213-9900
(801) 213-9910
Mailing address
PO BOX 510708, SALT LAKE CITY, UT 84151-0708
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5128554-4405
UT
Other
Enumeration date
07/02/2013
Last updated
11/03/2021
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