Kelly, Timothy A.

Kelly, Timothy A. is an individual health care provider with primary practice located at 900 S Auburn St , Kennewick WA 99336-5621. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Kelly, Timothy A. can be contacted via phone (509) 586-5840.

Contact Information

Primary practice address
900 S Auburn St Kennewick WA 99336-5621
Phone: (509) 586-5840
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN00100988 Washington
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP30003834 Washington

Profile Details

NPI number 1942244579
LBN Legal business name Kelly, Timothy A.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Nov 20th, 2007 - about 18 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 1942244579 NPPES
Oregon MEDICAID 262830
Oregon MEDICAID 9616996

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