| Doctor Name: | MR. DENNIS MICHAEL KELLEY |
| NPI Number: | 1568551398 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN NP |
| License Number: | COA 00187 |
| Business Practice Address: | 26600 Normandy Rd Bay Village, OH - 441402318 |
| Business Phone Number: | 4408358540 |
| Business Fax Number: | |
| Mailing Address: | 10701 East Blvd, Louis Stokes Cleveland Va Medical Center CLEVELAND |
| State: | OH |
| Postal Code: | 441061702 |
| Phone Number: | 2167913800 |
| Fax Number: | 2167075959 |
| NPI Enumeration Date: | 10/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | COA 00187 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |