Provider Demographics
NPI:1083235873
Name:ORGEL, KELLY ANN
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ANN
Last Name:ORGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:ANN
Other - Last Name:GEWAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PEDIATRIC EDUCATION OFFICE CB 7593
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7593
Mailing Address - Country:US
Mailing Address - Phone:919-966-3172
Mailing Address - Fax:919-966-8419
Practice Address - Street 1:1512 E FRANKLIN ST STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2816
Practice Address - Country:US
Practice Address - Phone:336-832-3150
Practice Address - Fax:984-974-5608
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-03
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC262754390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty