Kelly, Michael C
Kelly, Michael C is an individual health care provider with primary practice located at 413 Lilly Rd Ne , Olympia WA 98506-5133. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Kelly, Michael C can be contacted via phone (360) 491-9480.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | AP30006322 | Washington |
Profile Details
| NPI number | 1760425201 |
|---|---|
| LBN Legal business name | Kelly, Michael C |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Jul 6th, 2021 - about 4 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 | 1760425201 | NPPES |
| Other | 8906877 | WA CRIME VICTIMS | |
| Other | 6059KE | WA CRIME VICTIMS | |
| Other | 199382 | WA CRIME VICTIMS | |
| MEDICAID | 9635574 | WA CRIME VICTIMS |
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