| NPI | 1831115252 |
|---|---|
| Former Name | NANCY ANN KELLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085-001463) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-001463) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2007-07-08 |