Provider Demographics
NPI:1427790880
Name:KELLY, SUZANNE (CD(DONA))
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
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 1:18 PARKER PASS
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1764
Mailing Address - Country:US
Mailing Address - Phone:732-670-8242
Mailing Address - Fax:
Practice Address - Street 1:18 PARKER PASS
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1764
Practice Address - Country:US
Practice Address - Phone:732-670-8242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty