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:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063484889 | NPPES |
| North Carolina | Other | 185536 | MEDCOST |
| North Carolina | Other | 141MY | MEDCOST |
| North Carolina | MEDICAID | 7301880 | MEDCOST |
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