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General NPI Number Information
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NPI Number | 1265413272
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Entity Type | Individual
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Provider Name | KIMBERLY RENEE KELLEY MD
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Gender | Female
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 1 JARRETT WHITE RD TRIPLER ARMY MEDICAL CENTER
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City | TRIPLER AMC
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone | 808-433-2460
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Fax | 808-433-1558
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Provider Business Mailing Address
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Address Line | 92-1001 ALIINUI DR APT 17B
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City | KAPOLEI
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State | HI
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Zip | 96707-2255
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Country | US
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Telephone | 808-292-3192
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35055699
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01095424A
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License Number State | IN
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