Stafford, Kelly L.

Stafford, Kelly L. is an individual health care provider with primary practice located at 2001 Vail Ave Suite 200, Charlotte NC 28207-1219. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Stafford, Kelly L. can be contacted via phone (704) 323-2000.

Contact Information

Primary practice address
2001 Vail Ave Suite 200 Charlotte NC 28207-1219
Phone: (704) 323-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X MA051965 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0010-02443 North Carolina

Profile Details

NPI number 1184626806
LBN Legal business name Stafford, Kelly L.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Mar 21st, 2011 - about 15 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 1184626806 NPPES
Pennsylvania Other MA051965 MEDICAL PHYSICIAN ASST
Pennsylvania Other PA05336 MEDICAL PHYSICIAN ASST

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