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Individual

DR. KATHLEEN S. KELLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
498 UNIVERSITY BLVD, SUITE F, HARRISONBURG, VA 22801
(540) 432-1700
Mailing address
498 UNIVERSITY BLVD, SUITE F, HARRISONBURG, VA 22801
(540) 432-1700

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101045174
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010187257
VA
01
1000870001
DME PROVIDER
VA
01
1528917
CIGNA
VA
01
190072
ANTHEM/BCBS
VA
01
20552
OPTIMA
VA
01
329798
SOUTHERN HEALTH
01
3810003016
WV MEDICAID
Enumeration date
04/18/2006
Last updated
09/16/2009
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