Kelly, Teresa M

Kelly, Teresa M is an individual health care provider with primary practice located at 105 W 8Th Ave Ste 6020 , Spokane WA 99204-2319. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Kelly, Teresa M can be contacted via phone (509) 455-5050.

Contact Information

Primary practice address
105 W 8Th Ave Ste 6020 Spokane WA 99204-2319
Phone: (509) 455-5050
Fax: (509) 789-6204
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X AP30000509 Washington

Profile Details

NPI number 1104835578
LBN Legal business name Kelly, Teresa M
Credentials A.R.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 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 1104835578 NPPES
Washington MEDICAID 9616301

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