Individual
MRS. SAMANTHA JAYNE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
302 US-65, LINCOLN, MO 65338-2012
(660) 547-3915
Mailing address
31963 HWY AD, COLE CAMP, MO 65325-2823
(660) 281-1006
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2023027198
MO
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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