Kelly Lynn Gullestad, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

641852 Issued in NY

Practice address

14 Bellemeade Ave
Smithtown, NY 11787-1857

Phone

(631) 265-5300

NPI assigned

Jun 29, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Christian Nursing Registry Inc.

  • Home Health Agency
  • Smithtown, NY
  • NPI 1942587621
  NPD (past)
• Christian Nursing Registry, Inc.

  • Home Health Agency
  • Smithtown, NY
  • NPI 1912038274
  NPD (past)

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1346537347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ORMONT LN",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903017",
            "telephone_number": "631-708-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 BELLEMEADE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871857",
            "telephone_number": "631-265-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLESTAD",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "641852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yu Guan, MD
• Michelle Judith Guarino, LCSW
• Rachel Nicole Guglielmo
• Dominic Guida
• Phillip Tomas Guillen, MD
• Julie Gulotta, LPN
• Gabrielle B Gunsam
• Gregory J. Gunyan, D.O.
• Harvey Gutman, MD
• Aviva Guttmann, MSW, LMSW

• Registered Nurse in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.