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1376501395
TIMOTHY KELLEY
MEMPHIS, TN
NPI
1376501395
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: TN 10994)
Enumeration Date
2006-05-01
Last Update Date
2016-06-30
Business Address
Mr. TIMOTHY KELLEY CRNA
877 JEFFERSON AVE
MEMPHIS, TN 38103-2807
Phone number: 901-448-5893
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Mailing Address
Mr. TIMOTHY KELLEY CRNA
877 JEFFERSON AVE ATTN: PROVIDER ENROLLMENT
MEMPHIS, TN 38103-2807
Phone number:
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