Kelly Lynn Bragan, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2621441 Issued in NY

Practice address

49 Inglesid Lane
Liverpool, NY 13090

Phone

(315) 461-4240

NPI assigned

Aug 9, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186617600000",
    "number": "1104017524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 INGLESID LANE",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13090",
            "telephone_number": "315-461-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 INGLESID LANE",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13090",
            "telephone_number": "315-461-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGAN",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2007-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2621441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02059754",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cody Ashton Ryan Bowser
• Cassandra Lynn Boyce, LMT
• Karen Boyle
• Megan C. Boyles, PNP
• Brent A Bradford, DDS, PC
• Renea Braley, LMSW
• Brandon Bray, LPN
• Alexandrea Brazill
• Mark Philip Breazzano, M.D.
• Jacqueline M. Bressette, CRC, CASAC

• Licensed Practical Nurse in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.