| Doctor Name: | CAROL ANNETTE KELLY |
| NPI Number: | 1437407368 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | R871939 |
| Business Practice Address: | 655 South 7th Street Bldg 700/700a 78 Mdg/sgopf Robins Afb, GA - 31098 |
| Business Phone Number: | 4783277820 |
| Business Fax Number: | |
| Mailing Address: | 655 South 7th Street Bldg 700/700a, 78 Mdg/sgopf APO |
| State: | AA |
| Postal Code: | 31098 |
| Phone Number: | 4783277820 |
| Fax Number: | |
| NPI Enumeration Date: | 08/27/2012 |
| NPI Last Update Date: | 08/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R871939 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |