Luisa Jeanne Kenny, CRNP, AGPCNP-BC, CNS

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP017552 Issued in PA

Practice address

40 V Twin Dr
Gettysburg, PA 17325-7875

Phone

(717) 339-2790

NPI assigned

Sep 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Luisa Jeanne Grijalva Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Imperial Valley Family Care Medical Group Apc

  • General Practice Physician
  • Imperial, CA
  • NPI 1275581894
  Medicare reassignment NPD
• Imperial Valley Family Care Medical Group, Apc

  • Cardiac Rehabilitation Registered Nurse
  • Imperial, CA
  • NPI 1750112587
  NPD

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1215305453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 V TWIN DR",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173257875",
            "telephone_number": "717-339-2790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 West Aten Road",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Imperial",
            "state": "CA",
            "postal_code": "92251",
            "country_code": "US",
            "telephone_number": "760-355-8300",
            "fax_number": "760-545-0240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNY",
        "first_name": "LUISA",
        "middle_name": "JEANNE",
        "credential": "CRNP, AGPCNP-BC, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP017552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUISA",
            "last_name": "GRIJALVA",
            "middle_name": "JEANNE",
            "credential": "CRNP, AGPCNP-BC, CNS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Fetter Kellett, MS, LPC
• Regina Margaret Kelley, MSW
• Emalee Grace Kellison, PA-C
• Amy Kelly
• Kimberly Marie Ken, MD
• Melissa Dawn Kent, COTA
• Garrett Matthew Kepner, OTR/L
• Keystone Neuromonitoring Associates PC
• Tina Ashley Khair, D.O.
• Mohammad Ali Khan, MD

• Adult Health Nurse Practitioner in Gettysburg, PA
• Providers in Gettysburg, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.