Kelly, Peter James

Kelly, Peter James is an sole proprietor health care provider with primary practice located at 391 Broad St , Meriden CT 06450-5844. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Kelly, Peter James can be contacted via phone (203) 238-1555.

Contact Information

Primary practice address
391 Broad St Meriden CT 06450-5844
Phone: (203) 238-1555
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X E34306 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 000196 Connecticut

Profile Details

NPI number 1427148683
LBN Legal business name Kelly, Peter James
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 16th, 2006
Last updated May 19th, 2008 - about 16 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 1427148683 NPPES
Connecticut MEDICAID 430000104

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