Individual provider · Type 1 NPI

Larry Wayne Kelly Jr., PMHNP

Psychiatric/Mental Health Nurse Practitioner · Fairbanks, AK

NPI number 1487319869 Active

Practice location

1423 Peger Rd
Fairbanks, AK 99709-5169

Mailing address

906 Kingdom Come Dr
Cumberland, KY 40823-1547

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X183314 (AK)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1487319869

Larry Wayne Kelly Jr., PMHNP's National Provider Identifier is 1487319869, issued on Nov 1, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Fairbanks, AK. The record was last updated on Nov 1, 2021.