Doctor Name: | JILLIAN ELIZABETH KELLY |
NPI Number: | 1023456449 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | |
Business Practice Address: | 4290 William Flynn Highway Suite 205 Allison Park, PA - 15101 |
Business Phone Number: | 4124927546 |
Business Fax Number: | 4124927548 |
Mailing Address: | 4290 William Flynn Highway, Suite 205 ALLISON PARK |
State: | PA |
Postal Code: | 15101 |
Phone Number: | 4124927546 |
Fax Number: | 4124927548 |
NPI Enumeration Date: | 06/07/2013 |
NPI Last Update Date: | 10/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |