| Doctor Name: | MRS. DEBORAH ANN KICLITER-KELLY |
| NPI Number: | 1144476920 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP9198526 |
| Business Practice Address: | 1801 Se Hillmoor Dr Suite B109 Port Saint Lucie, FL - 349527553 |
| Business Phone Number: | 7723379473 |
| Business Fax Number: | 7723370796 |
| Mailing Address: | 5150 Nw Milner Dr, PORT ST LUCIE |
| State: | FL |
| Postal Code: | 349833392 |
| Phone Number: | 7724623800 |
| Fax Number: | 7724623865 |
| NPI Enumeration Date: | 08/13/2008 |
| NPI Last Update Date: | 05/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | ARNP9198526 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |