Provider Demographics
NPI:1518840263
Name:URSO, KELLY (NBCR)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:
Last Name:URSO
Suffix:
Gender:F
Credentials:NBCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-1957
Mailing Address - Country:US
Mailing Address - Phone:401-742-3625
Mailing Address - Fax:
Practice Address - Street 1:27 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-1957
Practice Address - Country:US
Practice Address - Phone:401-742-3625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173C00000X
RI173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist