Individual
MRS. KELLY MARIE BADURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8970 WINCHESTER RD, MEMPHIS, TN 38125
(901) 794-5806
(901) 794-7922
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1174
TN
Other
Enumeration date
01/30/2007
Last updated
09/14/2021
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