Kelley, Mark Donald

Kelley, Mark Donald is an individual health care provider with primary practice located at 100 Michigan St Ne , Grand Rapids MI 49503-2560. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Kelley, Mark Donald can be contacted via phone (616) 391-1680.

Contact Information

Primary practice address
100 Michigan St Ne Grand Rapids MI 49503-2560
Phone: (616) 391-1680
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704173671 Michigan

Profile Details

NPI number 1831130996
LBN Legal business name Kelley, Mark Donald
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Dec 10th, 2013 - about 11 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 1831130996 NPPES
Michigan Other P00725240 RAILROAD MEDICARE

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