Individual
KELLY JO ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7101 JAHNKE RD, RICHMOND, VA 23225-4017
(804) 483-2380
(804) 483-2381
Mailing address
17343 BURCHETT LN, BEAVERDAM, VA 23015-1779
(804) 878-4651
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0001292795
VA
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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