Individual
JACQUELINE ANN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
206 3RD ST NW, MOHALL, ND 58761-4105
(306) 540-7407
Mailing address
PO BOX 811, MOHALL, ND 58761-0811
(306) 540-7407
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
33918
ZZ
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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