Kelly, Bernadette Ann

Kelly, Bernadette Ann is an individual health care provider with primary practice located at 251 Turnpike Dr. , Folsom CA 95630. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as her primary health care specialty. Kelly, Bernadette Ann can be contacted via phone (916) 989-5930.

Contact Information

Primary practice address
251 Turnpike Dr. Folsom CA 95630
Phone: (916) 989-5930
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 207Q00000X California

Profile Details

NPI number 1407831530
LBN Legal business name Kelly, Bernadette Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Apr 14th, 2011 - about 13 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 1407831530 NPPES
California MEDICAID 00A055070
California Other A055070

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