KIM SHANTAE KELLEY

BRONX, NY
NPI1922283787
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  287751-1)
Enumeration Date2007-12-29
Last Update Date2007-12-29
Business Address
-- KIM SHANTAE KELLEY LPN
1705 HOE AVE APT 4B
BRONX, NY 10460-5345
Phone number: 347-224-0222
Mailing Address
-- KIM SHANTAE KELLEY LPN
1705 HOE AVE APT 4B
BRONX, NY 10460-5345
Phone number: 347-224-0222
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