Individual
KATHLEEN P KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4320 SEMINARY ROAD, ALEXANDRIA, VA 22304
(703) 504-3066
(703) 504-3866
Mailing address
1300 PICCARD DRIVE, SUITE 202, ROCKVILLE, MD 20850-4303
(301) 921-7900
(301) 921-7915
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
0101042375
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010158044
—
VA
Enumeration date
02/15/2006
Last updated
05/25/2023
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