Provider Demographics
NPI:1306660501
Name:KELLY, VICTORIA KAORI (CD(DONA))
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:KAORI
Last Name:KELLY
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5314 ARTHUR CIR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-1820
Mailing Address - Country:US
Mailing Address - Phone:757-708-1033
Mailing Address - Fax:
Practice Address - Street 1:5314 ARTHUR CIR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-1820
Practice Address - Country:US
Practice Address - Phone:757-708-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1409097374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula