Thatcher, Kelly Lee

Thatcher, Kelly Lee is an individual health care provider with primary practice located at 3001 W Dr Martin Luther King Jr Blvd Fl 1 , Tampa FL 33607. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Thatcher, Kelly Lee can be contacted via phone (813) 870-4619.

Contact Information

Primary practice address
3001 W Dr Martin Luther King Jr Blvd Fl 1 Tampa FL 33607
Phone: (813) 870-4619
Fax: (813) 554-8956
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Pediatrics 163WP0200X 9221346 Florida
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X ARNP9221346 Florida

Profile Details

NPI number 1568989317
LBN Legal business name Thatcher, Kelly Lee
Credentials ARNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2017
Last updated Aug 31st, 2018 - about 7 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 1568989317 NPPES
Florida MEDICAID 023380000

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