Individual
LYNN C KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1051 LOFTIS, SUITE 100, NEWPORT NEWS, VA 23606-4250
(757) 873-9400
(757) 873-9420
Mailing address
5900 LAKE WRIGHT DR, SUITE 300, NORFOLK, VA 23502-1871
(757) 213-5700
(757) 213-5701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001615
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
76055P
OPTIMA
VA
Enumeration date
06/23/2005
Last updated
04/28/2008
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