Individual
KELLY KAZLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
DAYTON VETERANS AFFAIRS, 4100 W THIRD STREET MAIL STOP 116, DAYTON, OH 45428
(937) 268-6511
Mailing address
DAYTON VETERANS AFFAIRS, 4100 W THIRD STREET MAIL STOP 116, DAYTON, OH 45428
(937) 268-6511
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
R126942
MD
363L00000X
Nurse Practitioner
R126942
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R126942
MD
Other
Enumeration date
08/05/2006
Last updated
06/27/2019
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