| NPI | 1710408315 |
|---|---|
| Former Name | MEGAN COLLEEN KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP017694) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN632662) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2023-05-25 |