Smith, Kelly

Smith, Kelly is an individual health care provider with primary practice located at 2232 Wilborn Ave Ste D , South Boston VA 24592-1662. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Smith, Kelly can be contacted via phone (434) 575-1212.

Contact Information

Primary practice address
2232 Wilborn Ave Ste D South Boston VA 24592-1662
Phone: (434) 575-1212
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 0024172518 Virginia

Profile Details

NPI number 1518353341
LBN Legal business name Smith, Kelly
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 8th, 2015
Last updated Apr 8th, 2015 - about 11 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 1518353341 NPPES
Virginia Other 0024172518 VA LICENSE

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