Karen Kelly, EDD, RN, NEA-BC

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

041-144845 Issued in IL

Practice address

Campus Box 1066
Southern Illinois University Edwardsville
Edwardsville, IL 62026-1066

Phone

(618) 650-3908

Fax

(618) 650-2522

NPI assigned

Aug 24, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251072000000",
    "number": "1396978441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAMPUS BOX 1066",
            "address_2": "SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620261066",
            "telephone_number": "618-650-3908",
            "fax_number": "618-650-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAMPUS BOX 1066",
            "address_2": "SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620261066",
            "telephone_number": "618-650-3908",
            "fax_number": "618-650-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "EDD, RN, NEA-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "IL",
            "license": "041-144845",
            "primary": true
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "MO",
            "license": "064395",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel James Keck-Flory, MD
• Melissa Keller
• Ranita R Keller, FNP
• Jeffery Jeane Kelley Jr.
• Madelyn Kelley
• Kenneth C Hyten & David W Hyten LTD
• Zhongxiang J Kenworthy
• Kevin Treloar Ma MSW LCSW
• Kid Glasses, Inc.
• Amy N Kief, RN

• Administrator Registered Nurse in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Administrator Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.