Individual
MARY MARGARET KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
116 TERRACE AVE, LODI, NJ 07644-2905
(973) 473-3896
Mailing address
116 TERRACE AVE, LODI, NJ 07644-2905
(973) 473-3896
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
NN42981
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
26NN04298100
NJ
Other
Enumeration date
10/11/2006
Last updated
07/21/2022
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