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General NPI Number Information
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NPI Number | 1568722544
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Entity Type | Individual
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Provider Name | AMBER LYN KELLEY RHD
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Gender | Female
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Dates
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Enumeration Date | 05/23/2012
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 333 CALIFORNIA AVE
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City | RENO
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State | NV
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Zip | 89509-1645
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Country | US
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Telephone | 775-323-3892
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Fax |
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Provider Business Mailing Address
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Address Line | 525 E 6TH AVE
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City | SUN VALLEY
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State | NV
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Zip | 89433-7542
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Country | US
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Telephone | 775-379-7478
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 101758
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License Number State | NV
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