KELLY BOARD

PEMBROKE PINES, FL
NPI1649719915
Former NameKELLY GILLIAM
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: MI  4704272053)
Additional Taxonomies363LA2200X Nurse Practitioner, Adult Health
(Licence: NC  5018989)
363LA2200X Nurse Practitioner, Adult Health
(Licence: AZ  303204)
363LA2200X Nurse Practitioner, Adult Health
(Licence: IL  209028496)
363LA2200X Nurse Practitioner, Adult Health
(Licence: CO  CAPN.0101629)
363LA2200X Nurse Practitioner, Adult Health
(Licence: FL  APRN9482729)
363LA2200X Nurse Practitioner, Adult Health
(Licence: OH  0033314)
363LA2200X Nurse Practitioner, Adult Health
(Licence: TX  1102491)
363LA2200X Nurse Practitioner, Adult Health
(Licence: TN  37319)
Enumeration Date2017-02-19
Last Update Date2024-11-26
Business Address
KELLY BOARD APRN, NP-C
880 SW 145TH AVE STE 202
PEMBROKE PINES, FL 33027-6171
Phone number: 866-849-0692
Mailing Address
KELLY BOARD APRN, NP-C
PO BOX 211699
EAGAN, MN 55121-3699
Phone number: 866-849-0692