Kelly, Michael D

Kelly, Michael D is an individual health care provider with primary practice located at 250 S 21St St , Easton PA 18042-3851. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Kelly, Michael D can be contacted via phone (610) 250-4303.

Contact Information

Primary practice address
250 S 21St St Easton PA 18042-3851
Phone: (610) 250-4303
Fax: (610) 250-4846
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN316546L Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 26NJ00335100 New Jersey

Profile Details

NPI number 1851380471
LBN Legal business name Kelly, Michael D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Feb 29th, 2012 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1851380471 NPPES
Pennsylvania Other 075242 AANA ID
Pennsylvania Other P00678819 AANA ID
Pennsylvania Other 26NR08257400 AANA ID
Pennsylvania MEDICAID 101495676 AANA ID

Popular Providers