| Doctor Name: | MISS MAXINE CORRINE KELLEY |
| NPI Number: | 1013352715 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 531166001 |
| Business Practice Address: | 8 Dill St Auburn, NY - 130213606 |
| Business Phone Number: | 3152531456 |
| Business Fax Number: | |
| Mailing Address: | 3965 Coye Rd, JAMESVILLE |
| State: | NY |
| Postal Code: | 130789780 |
| Phone Number: | 3154697235 |
| Fax Number: | |
| NPI Enumeration Date: | 05/08/2013 |
| NPI Last Update Date: | 05/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 531166001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |