Mumford, Kellie Lea

Mumford, Kellie Lea is an individual health care provider with primary practice located at 2147 Professional Dr , Gaylord MI 49735-0003. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mumford, Kellie Lea can be contacted via phone (989) 732-1753.

Contact Information

Primary practice address
2147 Professional Dr Gaylord MI 49735-0003
Phone: (989) 732-1753
Fax: (989) 731-1425
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601005363 Michigan

Profile Details

NPI number 1346496759
LBN Legal business name Mumford, Kellie Lea
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2008
Last updated Dec 23rd, 2020 - about 5 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 1346496759 NPPES
Other OF96004 MEDICARE GROUP NUMBER

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