Individual
LISA A. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,NP-C
Contact information
Practice address
12 KANAWHA TER, SAINT ALBANS, WV 25177-2750
(304) 201-1130
(304) 201-1134
Mailing address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9816
(304) 757-6999
(304) 201-5019
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
59915
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912317629
—
WV
Enumeration date
05/02/2014
Last updated
04/24/2025
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