Individual
JILLIAN ALEXANDRIA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(908) 644-6328
Mailing address
920 SOUTH ST APT 1, PHILADELPHIA, PA 19147-1983
(908) 644-6328
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP025030
PA
Other
Enumeration date
12/11/2021
Last updated
12/11/2021
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