TIMOTHY KELLEY

MEMPHIS, TN
NPI1376501395
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TN  10994)
Enumeration Date2006-05-01
Last Update Date2016-06-30
Business Address
Mr. TIMOTHY KELLEY CRNA
877 JEFFERSON AVE
MEMPHIS, TN 38103-2807
Phone number: 901-448-5893
Mailing Address
Mr. TIMOTHY KELLEY CRNA
877 JEFFERSON AVE ATTN: PROVIDER ENROLLMENT
MEMPHIS, TN 38103-2807
Phone number: