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Individual

JASMINE MARIE KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
91-2139 FORT WEAVER RD STE 303, EWA BEACH, HI 96706-3609
(808) 678-0700
Mailing address
91-2139 FORT WEAVER RD STE 303, EWA BEACH, HI 96706-3609
(808) 678-0700
(808) 678-0776

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21796
HI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/06/2018
Last updated
06/14/2021
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