Individual
GINA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
15655 STATE ROUTE 170 STE H, EAST LIVERPOOL, OH 43920-9672
(330) 932-0183
(330) 932-0240
Mailing address
PO BOX 645409, PITTSBURGH, PA 15264-5252
(330) 386-6442
(330) 386-3660
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.15388
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0094665
—
OH
05
—
3910000958
—
WV
Enumeration date
11/01/2013
Last updated
12/23/2022
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