Individual
CARLA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
726 4TH ST, MARYSVILLE, CA 95901-5656
(530) 749-4300
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
646369
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000952
SD
367500000X
Certified Registered Nurse Anesthetist
NA2506
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141720603
—
TX
01
—
P00266245
RR MEDICARE
GA
Enumeration date
06/26/2006
Last updated
06/12/2025
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