Individual
KELLY BOARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
0024194779
VA
363LA2200X
Adult Health Nurse Practitioner
0033314
OH
363LA2200X
Adult Health Nurse Practitioner
1102491
TX
363LA2200X
Adult Health Nurse Practitioner
209028496
IL
363LA2200X
Adult Health Nurse Practitioner
244045
LA
363LA2200X
Adult Health Nurse Practitioner
29709
SC
363LA2200X
Adult Health Nurse Practitioner
303204
AZ
363LA2200X
Adult Health Nurse Practitioner
37319
TN
363LA2200X
Adult Health Nurse Practitioner
Primary
4704272053
MI
363LA2200X
Adult Health Nurse Practitioner
5018989
NC
363LA2200X
Adult Health Nurse Practitioner
APRN9482729
FL
363LA2200X
Adult Health Nurse Practitioner
CAPN.0101629
CO
363LA2200X
Adult Health Nurse Practitioner
GAA-NP003047
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024999700
—
FL
Enumeration date
02/19/2017
Last updated
11/28/2025
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