Individual
BETH A KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, CNM
Contact information
Practice address
1717 E. CHICAGO ROAD, STURGIS, MI 49091-2372
(269) 659-6747
(269) 659-6746
Mailing address
1717 E CHICAGO RD, STURGIS, MI 49091-8524
(269) 659-6747
(269) 659-6746
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704194227
MI
363LF0000X
Family Nurse Practitioner
4704194227
MI
367A00000X
Advanced Practice Midwife
Primary
4704194227
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000612032
BCBS
IN
01
—
160G510560
BCBS GROUP-WOMENS SERVICES
MI
05
—
200932840
—
IN
01
—
700G560080
BCBS GROUP-THREE RIVERS HEALTH
MI
Enumeration date
05/01/2007
Last updated
12/06/2012
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