Doctor Name: | MS. MEGAN CAROLYN KELLS |
NPI Number: | 1427414572 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | SP015362 |
Business Practice Address: | 458 Town Sq Copperas Cove, TX - 765222826 |
Business Phone Number: | 2545535801 |
Business Fax Number: | |
Mailing Address: | 617 Fairview Ave, WOODBURY HEIGHTS |
State: | NJ |
Postal Code: | 080971401 |
Phone Number: | 8565356244 |
Fax Number: | |
NPI Enumeration Date: | 01/05/2016 |
NPI Last Update Date: | 01/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP015362 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |