Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 26NN07510600 | NJ |
N | 363LN0000X | Nurse Practitioner - Neonatal | LM-0000101 | DE |
N | 363LN0000X | Nurse Practitioner - Neonatal | R133433 | MD |
NPI | 1023131554 |
---|---|
Provider Name | Cynthia Jean Kelley |
First Address | Pilesgrove, NJ 08098-2414 |
Second Address | Pilesgrove, NJ 08098-2414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 08/07/2007 |