Individual
JANE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2035 SAINT JOHN AVE, DYERSBURG, TN 38024-2209
(731) 285-1393
(731) 660-8739
Mailing address
1804 HIGHWAY 45 BYP, STE 604, JACKSON, TN 38305-4436
(731) 512-1273
(731) 660-8739
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
51782
TN
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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