Kelly, Hallan

Kelly, Hallan is an individual health care provider with primary practice located at 222 W 39Th Ave , San Mateo CA 94403-4364. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Kelly, Hallan can be contacted via phone (650) 573-2222.

Contact Information

Primary practice address
222 W 39Th Ave San Mateo CA 94403-4364
Phone: (650) 573-2222
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X PA1011 California

Profile Details

NPI number 1619047198
LBN Legal business name Kelly, Hallan
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2006
Last updated Jul 8th, 2007 - about 19 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 1619047198 NPPES
California MEDICAID 0PA101100
California MEDICAID RN223958

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