Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Matthew Dean Kelly

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1164235826

Matthew Dean Kelly is a Student in an Organized Health Care Education/Training Program in Kirksville, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2025
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Practice location Address checks out

1509 Bishop Dr Apt D
Kirksville, MO 63501-2790
Phone: (509) 282-0495
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (MO)

Record details

NPI number1164235826
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 28, 2025
Last updated in NPPESJanuary 28, 2025
Certification dateJanuary 28, 2025

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