Individual
CHRISTOPHER PAUL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
161 MOUNT PELIA RD, MARTIN, TN 38237-3811
(731) 588-0001
(731) 587-2775
Mailing address
204 POPLAR ST, MARTIN, TN 38237-3121
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN 96601
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3631898
—
TN
01
—
4047865
BLUE CROSS/BLUE SHIELD TN
TN
Enumeration date
04/19/2006
Last updated
10/13/2011
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