Kellie Dawn Abe

Key facts

NPI

1033088083

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

R204449 (MD)

Practice address

114 Hideaway LN
Fort Ashby, WV 26719-6972

Phone

(301) 707-7276

NPI assigned

Oct 29, 2025

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 30, 2025.

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1033088083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HIDEAWAY LN",
            "city": "FORT ASHBY",
            "state": "WV",
            "postal_code": "267196972",
            "telephone_number": "301-707-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HIDEAWAY LN",
            "city": "FORT ASHBY",
            "state": "WV",
            "postal_code": "267196972",
            "telephone_number": "301-707-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABE",
        "first_name": "KELLIE",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R204449",
            "primary": true
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MD",
            "license": "R204449",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Fort Ashby, WV · Registered Nurse in West Virginia