Individual
KELLI PENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
307 TRENT DR, DURHAM, NC 27710-3038
(919) 684-4248
Mailing address
1352 AUGUSTUS BEAMON DR, INDIAN TRAIL, NC 28079-0390
(704) 776-2860
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
311421
NC
Other
Enumeration date
04/13/2026
Last updated
04/13/2026
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