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KELLY A SPRAY CNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1487095915

Individual Registrant:
 KELLY A SPRAY CNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
4317 W WOODMAN ST  PEQUOT LAKES, MN 56472-3473 US
Tel: 218-568-4416  Fax: --

Contact information for business:
523 N 3RD ST  BRAINERD, MN 56401-3054 US
Tel: 218-829-2861  Fax: --

Registration Information:
NPI: 1487095915
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
MNR194132-0

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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