Provider Demographics
NPI:1790010007
Name:AMEN, KELLY (PCD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:
Last Name:AMEN
Suffix:
Gender:F
Credentials:PCD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 ROCKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-5739
Mailing Address - Country:US
Mailing Address - Phone:484-678-2678
Mailing Address - Fax:
Practice Address - Street 1:308 ROCKLAND AVE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-5739
Practice Address - Country:US
Practice Address - Phone:484-678-2678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula