Provider Demographics
NPI:1326222985
Name:KELLY, SONDRA L (RN, MSN, CNS)
Entity Type:Individual
Prefix:MRS
First Name:SONDRA
Middle Name:L
Last Name:KELLY
Suffix:
Gender:F
Credentials:RN, MSN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 SPRING LINE DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-7156
Mailing Address - Country:US
Mailing Address - Phone:610-430-8283
Mailing Address - Fax:
Practice Address - Street 1:707 SPRING LINE DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-7156
Practice Address - Country:US
Practice Address - Phone:610-430-8283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN303305-L163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult