Stephanie Lynn Kelly, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP9971 Issued in AZ

Practice address

4475 S I 19 Frontage Rd Ste 139
Green Valley, AZ 85614-5884

Phone

(520) 407-5910

Fax

(520) 407-5990

NPI assigned

Mar 13, 2017

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)

Enrolled

Credentials

Master of Science - Nursing

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1497296362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 S CAMPBELL AVE",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140503",
            "telephone_number": "520-407-5600",
            "fax_number": "520-407-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 S I 19 FRONTAGE RD STE 139",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856145884",
            "telephone_number": "520-407-5910",
            "fax_number": "520-407-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marnie Lee Joseph
• Julia F. Granone, DPM, PC
• Cheyann Marie Kanavel, LMT
• William Francis Kazantzis, PHARMD
• John J Kelly, MD
• Ruth Catherine Kenrick, M.A., L.I. C.S.W.
• Kent H. Wyatt, D.D.S., P.C.
• Rossa Khalaf, MD
• Matthew Khumalo, MD
• Dawnie Kildoo, DDS

• Family Nurse Practitioner in Green Valley, AZ
• Providers in Green Valley, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.