| Doctor Name: | KELLEY C SHIRRON |
| NPI Number: | 1417250994 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | AC000784 |
| Business Practice Address: | 12150 Annapolis Rd Suite 208 Glenn Dale, MD - 207699183 |
| Business Phone Number: | 3012180398 |
| Business Fax Number: | |
| Mailing Address: | 12150 Annapolis Rd, Suite 208 GLENN DALE |
| State: | MD |
| Postal Code: | 207699183 |
| Phone Number: | 3012180398 |
| Fax Number: | |
| NPI Enumeration Date: | 12/06/2010 |
| NPI Last Update Date: | 12/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | AC000784 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |