| Doctor Name: | MRS. DIANE LEE KELLEY |
| NPI Number: | 1003998873 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | 1040028 |
| Business Practice Address: | 1276 North Locust Ave. First Floor Suite D Florence, AL - 356334425 |
| Business Phone Number: | 9317667056 |
| Business Fax Number: | 9317667057 |
| Mailing Address: | 1276 North Locust Ave., First Floor Suite D FLORENCE |
| State: | AL |
| Postal Code: | 356334425 |
| Phone Number: | 9317667056 |
| Fax Number: | 9317667057 |
| NPI Enumeration Date: | 10/20/2006 |
| NPI Last Update Date: | 11/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 1040028 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |