Kelly Lee, BSN, RN, PHN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

545994 Issued in CA

Practice address

25 N. Cottonwood St.
Adult and Aging Branch, Yolo County Hhsa
Woodland, CA 95695

Phone

(530) 666-8451

Fax

(530) 661-2673

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Kelly Jennings Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Yolo County Public Health Department

  • Public Health or Welfare Agency
  • Woodland, CA
  • NPI 1396758496
  NPD (past)

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1386191856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N. COTTONWOOD ST.",
            "address_2": "ADULT AND AGING BRANCH, YOLO COUNTY HHSA",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "95695",
            "telephone_number": "530-666-8451",
            "fax_number": "530-661-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N. COTTONWOOD ST.",
            "address_2": "ADULT AND AGING BRANCH, YOLO COUNTY HHSA",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "95695",
            "telephone_number": "530-666-8451",
            "fax_number": "530-661-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95025630",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "545994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "JENNINGS",
            "prefix": "MISS",
            "credential": "BSN, RN, PHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Monique Amber Leatherbury
• Amy L. Ledgerwood, M.D.
• Lee Wellness Chiropractic Corporation
• Brenda Cristine Lee, MPT
• Jason Michael Lee, DO
• Lynn Lee, PHARMD
• Marge Lee, P.A.
• Stacy Lee
• Terry Allan Lee, D.C.
• Randall H Leefeldt, M.D.

• Community Health Registered Nurse in Woodland, CA
• Providers in Woodland, CA by specialty
• Community Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.