Mrs Vivian A Kelley, NP in Fort Gordon, GA - Medicare Chore Provider

Mrs Vivian A Kelley, NP is a medicare enrolled "Chore Provider" in Fort Gordon, Georgia. Her current practice location is 300 W Hospital Road, Eisenhower Army Medical Center Attn Credentials, Fort Gordon, Georgia. You can reach out to her office (for appointments etc.) via phone at (706) 787-2720.

Mrs Vivian A Kelley is licensed to practice in Alabama (license number 1-050977) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1669539094.

Contact Information

	Mrs Vivian A Kelley, NP
	300 W Hospital Road, Eisenhower Army Medical Center Attn Credentials, Fort Gordon, GA 30905-5650
	(706) 787-2720
	(706) 787-8176

Provider's Profile

Full Name	Mrs Vivian A Kelley
Gender	Female
Speciality	Chore Provider
Location	300 W Hospital Road, Fort Gordon, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1669539094
Provider Enumeration Date: 01/03/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 7517005390
Enrollment ID: I20091116000527

Medical Identifiers

Medical identifiers for Mrs Vivian A Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1669539094	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	RN159555 (Georgia)	Primary
372500000X	Chore Provider	1-050977 (Alabama)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Vivian A Kelley is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Vivian A Kelley, NP 300 W. Hospital Road, Eisenhower Army Medical Center Attn Credentials, Fort Gordon, GA 30905-5650 Ph: (706) 787-2720	Mrs Vivian A Kelley, NP 300 W Hospital Road, Eisenhower Army Medical Center Attn Credentials, Fort Gordon, GA 30905-5650 Ph: (706) 787-2720

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Mrs Vivian A Kelley, NP - Medicare Chore Provider in Fort Gordon, GA