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:
Health care specialties
Specialty | Code | License # | 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 last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1275937179 | NPPES |
Florida | MEDICAID | 013647700 | |
Florida | MEDICAID | 003159917A |
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