Individual
MRS. T. NICOLE KELLEY
Active
Individual
MRS. T. NICOLE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MS, CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP008222
PA
363LA2100X
Acute Care Nurse Practitioner
Primary
R100906
MD
363LA2100X
Acute Care Nurse Practitioner
SP008222
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R100906
RN & CRNP LICENSE NUMBERS
MD
Enumeration date
02/13/2007
Last updated
01/13/2026
Update your record
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