| Doctor Name: | KELLI BUNN FLETCHER |
| NPI Number: | 1003292129 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 3189652 |
| Business Practice Address: | 92 W Miller St Orlando, FL - 328062032 |
| Business Phone Number: | 3218415104 |
| Business Fax Number: | |
| Mailing Address: | 14133 Tanja King Blvd, ORLANDO |
| State: | FL |
| Postal Code: | 328287772 |
| Phone Number: | 4073755353 |
| Fax Number: | |
| NPI Enumeration Date: | 07/31/2015 |
| NPI Last Update Date: | 07/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0222X |
| License Number: | 3189652 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics, Critical Care |
| Taxonomy Definition: | |