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Individual

SADE KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4556 RANDOLPH RD APT 92, CHARLOTTE, NC 28211-2964
(916) 544-9962
Mailing address
PO BOX 220231, CHARLOTTE, NC 28222-0231
(916) 544-9962

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle
376K00000X
Nurse's Aide
Primary

Other

Enumeration date
01/12/2023
Last updated
01/15/2023
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