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General NPI Number Information
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NPI Number | 1962458653
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Entity Type | Individual
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Provider Name | KIMBERLY A KELLY CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 310 FARM LN
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City | DOYLESTOWN
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State | PA
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Zip | 18901-4732
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Country | US
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Telephone | 215-348-3990
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Fax | 215-348-7705
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Provider Business Mailing Address
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Address Line | 310 FARM LN
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City | DOYLESTOWN
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State | PA
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Zip | 18901-4732
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Country | US
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Telephone | 215-348-3990
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Fax | 215-348-7705
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | TP006953C
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN332145L
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License Number State | PA
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