Individual
MS. MICHELLE M. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
BRYN MAWR HOSPITAL, 130 S. BRYN MAWR AVE., BRYN MAWR, PA 19010-3121
(610) 526-3000
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN502390L
PA
363LN0000X
Neonatal Nurse Practitioner
RN502390L
PA
363LN0005X
Critical Care Neonatal Nurse Practitioner
RN502390L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20770
—
NJ
05
—
4038827
—
MD
Enumeration date
10/26/2006
Last updated
09/23/2011
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