Provider Demographics
NPI:1245880947
Name:SAVILLE, KELLY ANNE (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:ANNE
Last Name:SAVILLE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 SCOLA RD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-1414
Mailing Address - Country:US
Mailing Address - Phone:610-945-8442
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN STANTON RD STE 1070
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-733-4534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0043825163W00000X
PARN649747163W00000X
PASP019855363LF0000X
DELG-0001319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse