Kelley, Lisa M

Kelley, Lisa M is an individual health care provider with primary practice located at 2711 Randolph Rd Suite 100, Charlotte NC 28207-2034. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Kelley, Lisa M can be contacted via phone (704) 342-9550.

Contact Information

Primary practice address
2711 Randolph Rd Suite 100 Charlotte NC 28207-2034
Phone: (704) 342-9550
Fax: (704) 377-0353
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 0024165508 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 0050-03621 North Carolina

Profile Details

NPI number 1669457420
LBN Legal business name Kelley, Lisa M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated Mar 2nd, 2011 - about 15 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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