Provider Demographics
NPI:1942581129
Name:COLUMBUS-CLINE, KELLY F (PA)
Entity Type:Individual
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First Name:KELLY
Middle Name:F
Last Name:COLUMBUS-CLINE
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1249 15TH ST
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3662
Mailing Address - Country:US
Mailing Address - Phone:304-691-1000
Mailing Address - Fax:304-691-1693
Practice Address - Street 1:1249 15TH ST
Practice Address - Street 2:SUITE 3000
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3662
Practice Address - Country:US
Practice Address - Phone:304-691-1000
Practice Address - Fax:304-691-1693
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2021-11-23
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Provider Licenses
StateLicense IDTaxonomies
WV01580363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant