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NPI Profile for JONATHAN D KELLY in FARMINGTON, NM.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI # | 1053529446 |
|
| Status | Active | |
| Credentials | PA.C. | |
| Entity | Individual | |
| Enumeration date | 05/18/2007 | |
| Last updated | 01/12/2023 - About 3 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JONATHAN D KELLY
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JONATHAN D KELLY, PA.C.