Individual
JAZZOLYNN KHALIYA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CRNP, FNP-BC
Contact information
Practice address
1753 CLARKSON ST, BALTIMORE, MD 21230-4809
(323) 253-5368
Mailing address
1753 CLARKSON ST, BALTIMORE, MD 21230-4809
(323) 253-5368
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R249163
MD
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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