Individual
HEATHER CHRISTINE KELLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(732) 687-5369
Mailing address
1415 N 31ST ST APT 204, PHILADELPHIA, PA 19121-3640
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MT215539
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT215539
PENNSYLVANIA LICENSING SYSTEM
PA
Enumeration date
06/05/2018
Last updated
05/25/2023
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