Kelley, Venda

Kelley, Venda is an individual health care provider with primary practice located at 2450 Tamiami Trl Ste A, Port Charlotte FL 33952-3922. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kelley, Venda can be contacted via phone (877) 856-3774.

Contact Information

Primary practice address
2450 Tamiami Trl Ste A Port Charlotte FL 33952-3922
Phone: (877) 856-3774
Fax: (239) 599-2612
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9429926 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3672P Kentucky

Profile Details

NPI number 1841294709
LBN Legal business name Kelley, Venda
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Oct 11th, 2016 - about 8 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 1841294709 NPPES
Other 2237571 CCN
Other C60195 CCN
Other 000000226588 CCN
MEDICAID 78007788 CCN
Other A574 CCN
MEDICAID 017319200 CCN
Other 6EFGA CCN
Other 1191652 CCN
Other 500026005 CCN

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