Kelly, Sean

Kelly, Sean is an individual health care provider with primary practice located at 1105 6Th St , Traverse City MI 49684-2349. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kelly, Sean can be contacted via phone (231) 947-0673.

Contact Information

Primary practice address
1105 6Th St Traverse City MI 49684-2349
Phone: (231) 947-0673
Fax: (801) 740-2847
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601008056 Michigan

Profile Details

NPI number 1285170738
LBN Legal business name Kelly, Sean
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2017
Last updated Mar 29th, 2021 - about 5 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 1285170738 NPPES
Michigan Other 5601008056 LICENSE

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