Active NPI
Johannan Elizabeth Kelly, RN
- Registered Nurse
- Neah Bay, WA
National Provider Identifier
1417105206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN00177063
- Practice address
- 250 Fort Street
Post Office Box 115
Neah Bay, WA 98357-0115 - Phone
- (360) 645-2194
- Fax
- (360) 645-2723
- NPI assigned
- Sep 4, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN00177063 | WA | Primary |
Addresses
Primary practice location
250 Fort Street
Post Office Box 115
Neah Bay, WA 98357-0115
Mailing address
PO Box 115
Neah Bay, WA 98357-0115
Phone (360) 645-2194
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00177063 | WA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220486400000",
"number": "1417105206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 115",
"city": "NEAH BAY",
"state": "WA",
"postal_code": "983570115",
"telephone_number": "360-645-2194",
"fax_number": "360-645-2723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 FORT STREET",
"address_2": "POST OFFICE BOX 115",
"city": "NEAH BAY",
"state": "WA",
"postal_code": "983570115",
"telephone_number": "360-645-2194",
"fax_number": "360-645-2723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JOHANNAN",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-04",
"last_updated": "2008-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN00177063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Neah Bay, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.