Individual
MS. MICHELLE MCCLEAF KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 27157-0001
(336) 549-6210
Mailing address
MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 27157-0001
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
172578
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078218
CRNA LICENSE
NC
Enumeration date
10/30/2007
Last updated
03/17/2018
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