Provider Demographics
NPI:1356456347
Name:LLOYD, KELLY ANN (MD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:LLOYD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:ANN
Other - Last Name:SCHOENECKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3560 MERIDIAN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1731
Mailing Address - Country:US
Mailing Address - Phone:360-734-2800
Mailing Address - Fax:360-734-3818
Practice Address - Street 1:3614 MERIDIAN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1748
Practice Address - Country:US
Practice Address - Phone:360-734-2800
Practice Address - Fax:360-734-3818
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00048389207ZP0102X, 207ZP0102X
WAML20008417207ZP0101X
MT28635207ZP0102X
UT10118582-1205207ZP0102X
IL036.142031207ZP0102X
ORMD169444207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMEDS7770OtherMEDICAL LICENSE
WAMD00048389OtherMEDICAL LICENSE