Individual
MARY ANN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
28 CRESCENT ST, MIDDLESEX HOSPITAL 7TH FL, MIDDLETOWN, CT 06457-3654
(860) 358-6760
(860) 358-4829
Mailing address
28 CRESCENT ST, MIDDLESEX HOSPITAL 7TH FL, MIDDLETOWN, CT 06457-3654
(860) 358-6760
(860) 358-4829
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
003508
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003508
CT APRN LICENSE
CT
Enumeration date
05/05/2008
Last updated
05/05/2008
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