Individual
KELLY S MCAULIFFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
15769 WC MAIN ST, MIDLOTHIAN, VA 23113-7327
(804) 419-9760
(804) 378-9140
Mailing address
15769 WC MAIN ST, MIDLOTHIAN, VA 23113-7327
(804) 419-9760
(804) 378-9140
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024166669
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05726
GROUP PTAN
VA
01
—
C05727
GROUP PTAN
VA
01
—
C05728
GROUP PTAN
VA
Enumeration date
10/13/2006
Last updated
05/23/2016
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