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General NPI Number Information
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NPI Number | 1407826696
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Entity Type | Individual
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Provider Name | NANCY P KELLEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 12/28/2016
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Provider Practice Location Address
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Address Line | 7655 5 MILE RD SUITE 101
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City | CINCINNATI
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State | OH
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Zip | 45230-4326
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Country | US
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Telephone | 513-231-3345
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Fax | 513-624-2588
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Provider Business Mailing Address
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Address Line | PO BOX 158 SUITE 101
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City | ESPANOLA
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State | NM
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Zip | 87532-0158
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Country | US
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Telephone | 505-753-7218
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Fax | 505-747-7396
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35061711
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License Number State | OH
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