Individual provider Active NPI

Kelli Lynn Queen, NNP-BC

  • Neonatal Nurse Practitioner
  • Morgantown, WV
National Provider Identifier
1407184831
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
0024168702 Issued in VA
Practice address
101 Stadium Drive
Morgantown, WV 26506-0000
Phone
(304) 598-4000
NPI assigned
Nov 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 62992 WV
Neonatal Nurse Practitioner 363LN0000X 0024168702 VA Primary

Addresses

Primary practice location

101 Stadium Drive
Morgantown, WV 26506-0000

Mailing address

PO Box 780
Morgantown, WV 26506-0000
Phone (304) 293-7401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100215000309 WV Practitioner - Nurse Practitioner 0840334868 Reassigns benefits to 2 organizations
I20140917000987 VA Practitioner - Nurse Practitioner 0840334868 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center Current Accepting new patients
Wheeling Hospital Inc CurrentSince Feb 1, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Sep 1, 2024 Accepting new patients
West Virginia University Medical Corporation CurrentSince Sep 1, 2024 Accepting new patients

Locations

220 Campus Blvd
Ste 320
Winchester, VA 22601

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

2000 Foundation Way
Ste 3100
Martinsburg, WV 25401
Phone (304) 260-1436

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

Interoperability endpoints

  • Direct secure messaging: kqueen124204@valleyhealth.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1407184831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265060000",
            "telephone_number": "304-293-7401",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 STADIUM DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265060000",
            "telephone_number": "304-598-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "KELLI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-23",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "WV",
            "license": "62992",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "VA",
            "license": "0024168702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.