Provider Demographics
NPI:1114350840
Name:O'REILLY ALBER, KELLY JO (ARNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:JO
Last Name:O'REILLY ALBER
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:JO
Other - Last Name:O'REILLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1522 220TH ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-8948
Mailing Address - Country:US
Mailing Address - Phone:563-927-3708
Mailing Address - Fax:
Practice Address - Street 1:619 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IA
Practice Address - Zip Code:52310-1733
Practice Address - Country:US
Practice Address - Phone:319-465-5937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA115009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily