Individual
KELTSIE S. KELLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
317 WESTERN BLVD, JACKSONVILLE, NC 28546-6338
(910) 577-2240
Mailing address
307 S EVERGREEN AVE, WOODBURY, NJ 08096-2739
(856) 686-4317
(856) 848-8536
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
500597
NC
Other
Enumeration date
03/25/2011
Last updated
03/25/2011
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