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Individual

KELLI CANADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, IBCLC

Contact information

Practice address
1327 ROBESON ST, FAYETTEVILLE, NC 28305-5531
(910) 486-5437
Mailing address
1327 ROBESON ST, FAYETTEVILLE, NC 28305-5531
(910) 486-5437

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
286991
NC
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L42213
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L-42213
IBCLC
Enumeration date
07/26/2017
Last updated
07/21/2022
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