O'Brien, Kelly

O'Brien, Kelly is an sole proprietor health care provider with primary practice located at 1680 The Greens Way Ste 200 , Jacksonville Beach FL 32250-1422. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. O'Brien, Kelly can be contacted via phone (904) 800-7380.

Contact Information

Primary practice address
1680 The Greens Way Ste 200 Jacksonville Beach FL 32250-1422
Phone: (904) 800-7380
Fax: (904) 467-8932
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 9270387 Florida
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 9270387 Florida

Profile Details

NPI number 1275937179
LBN Legal business name O'Brien, Kelly
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2014
Last updated Jul 15th, 2024 - about 4 months 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 1275937179 NPPES
Florida MEDICAID 013647700
Florida MEDICAID 003159917A

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