Individual
STACY MICHELLE RODRIGUEZ-KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23625 HOLMAN HWY, MONTEREY, CA 93940-5902
(831) 625-4511
Mailing address
3215 DEFOREST ROAD, MARINA, CA 93933
(831) 402-3263
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95008637
CA
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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