Individual
KELLY ANNE O'CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
10 SHURS LN STE 203, PHILADELPHIA, PA 19127-2123
(215) 482-1234
Mailing address
10 SHURS LN STE 203, PHILADELPHIA, PA 19127-2123
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN628832
PA
363L00000X
Nurse Practitioner
Primary
SP019217
PA
Other
Enumeration date
03/04/2015
Last updated
10/16/2018
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