Lisa Marie Kelly, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

9402875 Issued in FL

Practice address

10 E Front St Apt B
Monroe, MI 48161-2269

Phone

(734) 497-9041

NPI assigned

Jul 16, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1164075453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 E FRONT ST APT B",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481612269",
            "telephone_number": "734-497-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E FRONT ST APT B",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481612269",
            "telephone_number": "734-497-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704176148",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9402875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marie Keller, S.T
• Natalie Keller
• Tammie L Kelley Stahr, RN
• Jennifer Ann Kelley, LMSW
• Timothy James Kellie, CNP
• Oscar Kelly
• Ketamine Institute of Michigan
• Phyllis Ann Kettlewell, CRNA
• Azadeh Khaghany, M.D.
• Ashar Humayun Khan, MD

• Nurse Practitioner in Monroe, MI
• Providers in Monroe, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.