Kelly, Patricia Mary

Kelly, Patricia Mary is an individual health care provider with primary practice located at 1270 Kotnum Road , Warm Springs OR 97761. She recently has only one registered license in Nursing Service Providers / Ambulatory Care, which is considered as her primary health care specialty. Kelly, Patricia Mary can be contacted via phone (541) 553-1196.

Contact Information

Primary practice address
1270 Kotnum Road Warm Springs OR 97761
Phone: (541) 553-1196
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Ambulatory Care 163WP2201X RN00074801 Washington

Profile Details

NPI number 1295819076
LBN Legal business name Kelly, Patricia Mary
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated Aug 4th, 2011 - about 14 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 1295819076 NPPES
Oregon MEDICAID 237855

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