Kelly, Martin J

Kelly, Martin J is an individual health care provider with primary practice located at 2710 Rife Medical Ln , Rogers AR 72758-1452. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Kelly, Martin J can be contacted via phone (913) 642-4900.

Contact Information

Primary practice address
2710 Rife Medical Ln Rogers AR 72758-1452
Phone: (913) 642-4900
Fax: (913) 381-0979
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X C002728 Arkansas

Profile Details

NPI number 1851575476
LBN Legal business name Kelly, Martin J
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2007
Last updated Nov 7th, 2013 - about 13 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 1851575476 NPPES
Arkansas Other P00849069 RR
Arkansas MEDICAID 176438001 RR
Arkansas Other 5V105 RR
Arkansas Other 604337200 RR

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