Provider Demographics
NPI:1841027349
Name:KELLY, EMILY ANN (APRN-CNP, FNP-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:KELLY
Suffix:
Gender:F
Credentials:APRN-CNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:OH
Mailing Address - Zip Code:44672-1643
Mailing Address - Country:US
Mailing Address - Phone:877-469-7476
Mailing Address - Fax:330-537-4482
Practice Address - Street 1:605 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:OH
Practice Address - Zip Code:44672-1643
Practice Address - Country:US
Practice Address - Phone:877-469-7476
Practice Address - Fax:330-537-4482
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0037545363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty