Provider Demographics
NPI:1083061253
Name:KIELY, KATE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:ELIZABETH
Last Name:KIELY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATE
Other - Middle Name:ELIZABETH
Other - Last Name:KIELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:1247 E ALLUVIAL AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2686
Practice Address - Country:US
Practice Address - Phone:559-431-6226
Practice Address - Fax:559-440-9005
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1868902086S0129X
NC301322208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery