Provider Demographics
NPI:1336901016
Name:DEFLORA, KELLI (CD(DONA))
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:DEFLORA
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2902
Mailing Address - Country:US
Mailing Address - Phone:201-259-0400
Mailing Address - Fax:
Practice Address - Street 1:113 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3849
Practice Address - Country:US
Practice Address - Phone:201-259-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula