| NPI | 1760052260 |
|---|---|
| Former Name | EMILY MARIE KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209023669) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041455321) |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2023-01-26 |