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General NPI Number Information
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NPI Number | 1891154233
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Entity Type | Individual
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Provider Name | CHRISTINA KELLY DC, CPM, LM
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Gender | Female
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Dates
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Enumeration Date | 02/13/2016
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 11 10TH AVE S STE D
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City | HOPKINS
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State | MN
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Zip | 55343-7505
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Country | US
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Telephone | 952-452-9712
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Fax |
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Provider Business Mailing Address
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Address Line | 1207 CARLSBAD VILLAGE DR STE U
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City | CARLSBAD
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State | CA
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Zip | 92008-1958
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Country | US
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Telephone | 760-730-7315
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 1101
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7203
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License Number State | MN
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