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NPI Code Detail

MEDICARE: MRS. CAMERON LEIGH KELLY BSW

MEDICARE:  MRS. CAMERON LEIGH KELLY  BSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1588094627
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAMERON LEIGH KELLY BSW
Provider Business Mailing Address
First Line : 217 TALLEY DR
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-4653
Country : US
Telephone Number : 727-729-9507
Fax Number :
Provider Business Practice Location Address
First Line : 217 TALLEY DR
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-4653
Country : US
Telephone Number : 727-729-9507
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2013
Last Update Date : 11/26/2013

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Directions to “ MRS. CAMERON LEIGH KELLY BSW” Practice Location

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