Jennifer Kelliher, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP045319 Issued in AZ

Practice address

1025 N Country Club Dr
Mesa, AZ 85201-3307

Phone

(480) 824-8608

NPI assigned

Aug 26, 2015

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1427425388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14333 E GERONIMO RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852593783",
            "telephone_number": "480-824-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013307",
            "telephone_number": "480-824-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLIHER",
        "first_name": "JENNIFER",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP045319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kazhra Angelique Mayan Kelcho
• Renee L Kelderhouse, M.S., CCC-SLP
• Duke Keller, D.O
• Molly Johanna Keller, BS, BHPP
• Kelli Sieczkowski, PLLC
• Julianna Kellner
• Olivia Kellogg
• Hannah Kelly, MA
• John Duane Kelly III, DC
• Kristi Kelly, PHARMD

• Licensed Practical Nurse in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Licensed Practical Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; 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.