Doctor Name: | PATRICIA ANN KELLY |
NPI Number: | 1215015409 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | NUR-RN-LIC-9177 |
Business Practice Address: | 5 4th Ave. E Polson, MT - 59860 |
Business Phone Number: | 4067453525 |
Business Fax Number: | 4067453529 |
Mailing Address: | P.o. Box 880, ST. IGNATIUS |
State: | MT |
Postal Code: | 59865 |
Phone Number: | 4067453525 |
Fax Number: | 4067453529 |
NPI Enumeration Date: | 11/02/2006 |
NPI Last Update Date: | 09/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | NUR-RN-LIC-9177 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |