Individual
MAIZEE BLACK KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA, APRN, DNP
Contact information
Practice address
700 W MARKET ST, ATHENS, AL 35611-2457
(256) 233-9292
Mailing address
14041 SEVEN MILE POST RD, ATHENS, AL 35611-8483
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-135574
AL
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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