Vicki Amanda Kelley CRNP

NPI 1093130791 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1093130791
Gender Female
Enumeration Date 03/04/2014
Last Updated 03/04/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
847 BOLL WEEVIL CIR
SUITE 110
ENTERPRISE AL, 36330-2472, US
Phone (334) 489-4110
Fax (334) 489-4165
Business Location
104 MEDICAL DR
DOTHAN AL, 36303-6902, US
Phone (334) 671-9445
Fax (334) 836-0059
Toxanomy
Taxonomy Code 363LF0000X
License State Alabama
License Number 1-101347
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According to our database, Vicki Amanda Kelley CRNP NPI is 1093130791, taxonomy code is 363LF0000X and license number is 1-101347, license state is located at Alabama. Vicki Amanda Kelley CRNP physically located at 847 Boll Weevil Cir, Enterprise AL, 36330-2472. NPI Number Vicki Amanda Kelley CRNP has the Individual type.

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1093130791 NPI number is provided on an as is basis without warranty of any kind. 1093130791 is maintained by the National Plan & Provider Enumeration System. The contents of Vicki Amanda Kelley CRNP are for informational purposes only.