Provider Demographics
NPI:1356461990
Name:KELLY, ALISHA B (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:B
Last Name:KELLY
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:667 KINGSBOROUGH SQ STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4999
Mailing Address - Country:US
Mailing Address - Phone:757-842-4481
Mailing Address - Fax:757-312-3135
Practice Address - Street 1:111 MEDICAL PKWY FL 2
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-0302
Practice Address - Country:US
Practice Address - Phone:757-312-4047
Practice Address - Fax:757-410-0339
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2025-08-18
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Provider Licenses
StateLicense IDTaxonomies
PAUP006842C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health