Individual
AMY HENDERSON KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1001 BLYTHE BLVD, CHARLOTTE, NC 28203-5866
(704) 381-9900
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
300250
NC
363LP0200X
Pediatric Nurse Practitioner
300250
NC
Other
Enumeration date
07/15/2005
Last updated
08/05/2024
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