Kelly, Brennan L
Kelly, Brennan L is an sole proprietor health care provider with primary practice located at 3700 Southern Blvd Ste 300 , Kettering OH 45429-1226. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Kelly, Brennan L can be contacted via phone (937) 643-9299.Contact Information
Primary practice address
3700 Southern Blvd Ste 300
Kettering OH 45429-1226
Phone: (937) 643-9299
Fax: (937) 643-2343
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 50004106 | Ohio |
Profile Details
| NPI number | 1881096311 |
|---|---|
| LBN Legal business name | Kelly, Brennan L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 16th, 2014 |
| Last updated | Jan 20th, 2021 - about 3 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 | 1881096311 | NPPES |
| Ohio | MEDICAID | 0110411 |
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