Individual
KATHLEEN MARY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
137 MAIN RD, SUITE 200, MONTVILLE, NJ 07045-9231
(973) 402-0025
(973) 402-0508
Mailing address
137 MAIN RD, SUITE 200, MONTVILLE, NJ 07045-9231
(973) 402-0025
(973) 402-0508
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
PENDING
NJ
Other
Enumeration date
01/03/2008
Last updated
11/29/2010
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