Individual
MR. PATRICK RYAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
24760 HOSPITAL DRIVE, RED LAKE, MN 56671
(218) 679-0396
Mailing address
911 MAPLE RIDGE CT NW, BEMIDJI, MN 56601-8009
(605) 370-7669
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10241
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1098752
TX
Other
Enumeration date
11/03/2011
Last updated
07/14/2023
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