| NPI | 1992046007 |
|---|---|
| Former Name | SUSAN ELIZABETH KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11008598) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN218214) |
| 363L00000X Nurse Practitioner (Licence: CO APN.0992170-NP) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0992170-NP) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN218214) | |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2024-12-18 |