Individual
CRYSTAL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
903 NORTHEAST DR, SUITE 301, DAVIDSON, NC 28036-7416
(704) 894-9309
Mailing address
143 DRAPER DR, STATESVILLE, NC 28625-2541
(704) 682-3194
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200588
NC
Other
Enumeration date
05/06/2015
Last updated
05/06/2015
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