Provider Demographics
NPI:1336985845
Name:KELLEY, CURRYN (BSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:CURRYN
Middle Name:
Last Name:KELLEY
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 MEGINNES RD
Mailing Address - Street 2:
Mailing Address - City:KINTNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18930-1624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:233 UPPER GREEN HILL RD
Practice Address - Street 2:
Practice Address - City:KUNKLETOWN
Practice Address - State:PA
Practice Address - Zip Code:18058
Practice Address - Country:US
Practice Address - Phone:484-886-9923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN696909163W00000X
PAL-312416163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse