Colleen E Kelly PA

NPI 1568695799 - Physician Assistant - 363A00000X

NPI Details
NPI 1568695799
Gender Female
Enumeration Date 09/04/2009
Last Updated 09/13/2013
Entity Type Individual
Active Over 8 years ago
Practice Location
SPRINGFIELD IL, 62704-5352, US
Phone (217) 528-7541
Fax (217) 528-8962
Business Location
1025 S 6TH ST
SPRINGFIELD IL, 62703-2403, US
Phone (217) 528-7541
Fax (217) 528-8962
Taxonomy Code 363A00000X
License State Illinois
License Number 085003555
Remove 1568695799 NPI Number

According to our database, Colleen E Kelly PA NPI is 1568695799, taxonomy code is 363A00000X and license number is 085003555, license state is located at Illinois. Colleen E Kelly PA physically located at 2200 Wabash Ave, Springfield IL, 62704-5352. NPI Number Colleen E Kelly PA has the Individual type.

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1568695799 NPI number is provided on an as is basis without warranty of any kind. 1568695799 is maintained by the National Plan & Provider Enumeration System. The contents of Colleen E Kelly PA are for informational purposes only.