Kelly, Larry Wayne

Kelly, Larry Wayne is an individual health care provider with primary practice located at 1423 Peger Rd , Fairbanks AK 99709-5169. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Kelly, Larry Wayne can be contacted via phone (907) 371-1300.

Contact Information

Primary practice address
1423 Peger Rd Fairbanks AK 99709-5169
Phone: (907) 371-1300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 183314 Alaska

Profile Details

NPI number 1487319869
LBN Legal business name Kelly, Larry Wayne
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2021
Last updated Nov 1st, 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.

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