Provider Demographics
NPI:1245100643
Name:CURRY, KELLYN DANIEL
Entity type:Individual
Prefix:
First Name:KELLYN
Middle Name:DANIEL
Last Name:CURRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3D RECON BN
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96388-8002
Mailing Address - Country:US
Mailing Address - Phone:315-625-7036
Mailing Address - Fax:
Practice Address - Street 1:3D RECON BN
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96388-8002
Practice Address - Country:US
Practice Address - Phone:315-625-7036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL08243550KC1710I1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical TechniciansGroup - Multi-Specialty