Individual
MRS. AMANDA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6225 N STATE HIGHWAY 161 STE 200, IRVING, TX 75038-2241
(214) 687-0001
(972) 518-2100
Mailing address
127 STONY FORD RD, CAMPBELL HALL, NY 10916-2215
(618) 830-7389
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041447705
IL
Other
Enumeration date
01/26/2017
Last updated
11/08/2018
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