Fonville, Kelly Anne

Fonville, Kelly Anne is an sole proprietor health care provider with primary practice located at 3301 Overbrook Dr , Conover NC 28613-8227. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Fonville, Kelly Anne can be contacted via phone (828) 256-9488.

Contact Information

Primary practice address
3301 Overbrook Dr Conover NC 28613-8227
Phone: (828) 256-9488
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 5956 North Carolina

Profile Details

NPI number 1063484889
LBN Legal business name Fonville, Kelly Anne
Credentials MS OTR IL
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 6th, 2006
Last updated Jul 25th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063484889 NPPES
North Carolina Other 185536 MEDCOST
North Carolina Other 141MY MEDCOST
North Carolina MEDICAID 7301880 MEDCOST

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