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Individual

MRS. KELLY E POWELL-GRIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-C

Contact information

Practice address
14100 FIVAY RD STE 265, HUDSON, FL 34667-7151
(727) 819-2945
(727) 819-2970
Mailing address
9488 HERNANDO RIDGE RD, WEEKI WACHEE, FL 34613-6446
(727) 819-2945
(727) 819-2970

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3085712
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023965429
FL
Enumeration date
12/08/2008
Last updated
04/16/2025
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