Kelly, Melissa D

Kelly, Melissa D is an individual health care provider with primary practice located at 802 Green Valley Rd Ste. 210, Greensboro NC 27408-7041. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Kelly, Melissa D can be contacted via phone (336) 510-5510.

Contact Information

Primary practice address
802 Green Valley Rd Ste. 210 Greensboro NC 27408-7041
Phone: (336) 510-5510
Fax: (336) 810-5515
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Pediatrics 163WP0200X ARNP9169528 Florida
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 5008997 North Carolina

Profile Details

NPI number 1629180849
LBN Legal business name Kelly, Melissa D
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2006
Last updated Oct 17th, 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 1629180849 NPPES
Florida MEDICAID 307942200

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