Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | 1024243 | DC |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 719890 | TX |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | SP017152 | PA |
NPI | 1043589716 |
---|---|
Provider Name | Kelli M Mcneely |
First Address | Philadelphia, PA 19134-1011 |
Second Address | Philadelphia, PA 19134-1011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2011 |
Last Update Date | 13/03/2017 |