Individual
MRS. LEISHA KAE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6110 SHALLOWFORD ROAD, SUITE B, CHATTANOOGA, TN 37421
(423) 499-1031
(423) 296-6384
Mailing address
6110 SHALLOWFORD RD STE B, CHATTANOOGA, TN 37421-1894
(423) 499-1031
(423) 296-6384
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
56055
TN
164W00000X
Licensed Practical Nurse
86055
TN
Other
Enumeration date
07/31/2017
Last updated
07/21/2022
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