Individual
MS. LAUREN ALEXIS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
126 PARK AVE, BRIDGEPORT, CT 06604-7620
(203) 576-4552
Mailing address
73 EASTLAWN ST, FAIRFIELD, CT 06824-6417
(203) 767-8728
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/03/2017
Last updated
06/03/2017
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