Individual
MYRA D KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
801 GREEN VALLEY RD, GREENSBORO, NC 27408-7021
(336) 832-6500
Mailing address
PO BOX 26580, GREENSBORO, NC 27415-6580
(336) 832-6500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
61785
NC
367500000X
Certified Registered Nurse Anesthetist
35810
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050441
—
NC
Enumeration date
02/12/2007
Last updated
09/11/2025
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