Kellie R. Parker, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71007937A Issued in IN

Practice address

1275 Provident Dr
Warsaw, IN 46580-3265

Phone

(574) 269-4026

Fax

(574) 269-7444

NPI assigned

Apr 3, 2018

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

Other names 1

• Kellie R. Swafford Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1467958975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 E DUPONT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251675",
            "telephone_number": "260-432-4400",
            "fax_number": "260-969-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 PROVIDENT DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803265",
            "telephone_number": "574-269-4026",
            "fax_number": "574-269-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "KELLIE",
        "middle_name": "R.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007937A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "SWAFFORD",
            "middle_name": "R.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alta Jane Overholser, MA, LMHC
• PA Labs Inc
• Bohyun Park, MA
• Sung Jae Park, M.D.
• Amber Rae Parker, PTA
• Kimberly Parker, RN
• Marlene Parker, HSPP
• Parkview Kosciusko Surgery One, LLC
• Karlee Paul
• Polly Ann Pavey, MSW

• Family Nurse Practitioner in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.