| NPI | 1053714436 |
|---|---|
| Former Name | KELLY A. FAHEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.16598) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA.16598-NP) |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2018-03-02 |