Provider Demographics
NPI:1518474907
Name:KOLB, KELLY (CD/PCD(DONA))
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:KOLB
Suffix:
Gender:F
Credentials:CD/PCD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 N TYSON AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-3019
Mailing Address - Country:US
Mailing Address - Phone:215-713-5899
Mailing Address - Fax:
Practice Address - Street 1:425 N TYSON AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-3019
Practice Address - Country:US
Practice Address - Phone:215-713-5899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-07
Last Update Date:2018-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula