Kelty, Jenny Lee

Kelty, Jenny Lee is an individual health care provider with primary practice located at 2730 A Prosperity Avenue , Fairfax VA 22031-2238. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Pulmonology, which is considered as her primary health care specialty. Kelty, Jenny Lee can be contacted via phone (703) 289-1410.

Contact Information

Primary practice address
2730 A Prosperity Avenue Fairfax VA 22031-2238
Phone: (703) 289-1410
Fax: (703) 289-1420
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X 0101236840 Virginia

Profile Details

NPI number 1205893021
LBN Legal business name Kelty, Jenny Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Dec 5th, 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 1205893021 NPPES
Virginia MEDICAID 010103797
Virginia MEDICAID 010103789
Virginia MEDICAID 0101037762
Virginia MEDICAID 010087309

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