Individual provider Active NPI

Kieran Tully

  • Registered Nurse
  • Hollywood, FL
National Provider Identifier
1497673602
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
9506488 Issued in FL
Practice address
309 N 21St Ave
Hollywood, FL 33020-4537
Phone
(305) 899-3000
NPI assigned
Jul 7, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9506488 FL Primary

Addresses

Primary practice location

309 N 21St Ave
Hollywood, FL 33020-4537

Mailing address

9952 Robins Nest Rd
Boca Raton, FL 33496-2101
Phone (561) 909-9111

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

NPI Registry JSON

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

{
    "created_epoch": "1783382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1497673602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9952 ROBINS NEST RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962101",
            "telephone_number": "561-909-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 N 21ST AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204537",
            "telephone_number": "305-899-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "KIERAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-07",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9506488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.