Individual
MS. KELLI MAUREEN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
110 KILDAIRE FARM RD, CHARLOTTE, NC 27518-8162
(919) 235-6575
(919) 235-6598
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-8991
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5011726
NC
Other
Enumeration date
10/14/2015
Last updated
12/16/2022
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