Individual
KELLI KRISTIANA GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4880 N HIGHWAY 19A STE 200, MOUNT DORA, FL 32757-2018
(352) 589-8111
Mailing address
2023 TOURNAMENT DR, APOPKA, FL 32712-2022
(813) 230-0455
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
11001066
FL
Other
Enumeration date
05/17/2019
Last updated
10/21/2019
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