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General NPI Number Information
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NPI Number | 1144665316
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Entity Type | Individual
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Provider Name | KELLI JARRETT MD
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Gender | Female
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Dates
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Enumeration Date | 05/01/2013
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 744 N MARINE CORPS DR STE 121
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City | TAMUNING
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State | GU
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Zip | 96913-4426
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Country | US
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Telephone | 671-588-2394
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Fax |
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Provider Business Mailing Address
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Address Line | 744 N MARINE CORPS DR STE 121
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City | TAMUNING
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State | GU
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Zip | 96913-4426
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Country | US
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Telephone | 671-588-2394
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60633045
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MED-PHYS-LIC-59169
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M-2417
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License Number State | GU
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