Provider Demographics
NPI:1225809916
Name:KELLY, EMILY (CD (DONA), HCHD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KELLY
Suffix:
Gender:F
Credentials:CD (DONA), HCHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 HIGHLAND RHODES DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-3461
Mailing Address - Country:US
Mailing Address - Phone:919-368-0897
Mailing Address - Fax:
Practice Address - Street 1:525 HIGHLAND RHODES DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-3461
Practice Address - Country:US
Practice Address - Phone:919-368-0897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula