Individual
KELLY ELIZABETH FANTOZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3636 HIGH STREET, MARY VIEW MEDICAL CENTER, PORTSMOUTH, VA 23704
(757) 399-7461
(757) 399-1158
Mailing address
355 CRAWFORD ST STE 808, PORTSMOUTH, VA 23704-2825
(757) 399-7451
(757) 399-1158
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001169731
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0001169731
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024166903
VA
Other
Enumeration date
06/21/2006
Last updated
02/16/2026
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