Individual
KATHLEEN MARIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA, RN
Contact information
Practice address
900 11TH ST SE, BANDON, OR 97411-9114
(541) 347-2426
(541) 347-3923
Mailing address
900 11TH ST SE, BANDON, OR 97411-9114
(541) 347-2426
(541) 347-3923
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
044645
OR
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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