Individual
MRS. ANNE GERISE KELLY
Active
Individual
MRS. ANNE GERISE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT016085
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001682843
HIGHMARK BLUESHIELD
PA
05
—
1011197760001
—
PA
01
—
2356289000
IBC
PA
Enumeration date
03/03/2006
Last updated
10/11/2019
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