Holly Jo Kelly, RNFA CNOR

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

025801 RN00114875 Issued in WA

Practice address

520 N 4TH Ave
Pasco, WA 99301-5257

Phone

(509) 546-2203

Fax

(509) 546-2262

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639257595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 N WHITMAN ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984071547",
            "telephone_number": "253-759-3065",
            "fax_number": "253-759-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 4TH AVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015257",
            "telephone_number": "509-546-2203",
            "fax_number": "509-546-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "HOLLY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "RNFA CNOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "WA",
            "license": "025801 RN00114875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9632084",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayshuv Enterprises, LLC
• Kayshuv Enterprises, LLC
• Rachel Keddison
• Mary Therese Keech
• Anna R Kelly
• Joshua Stephen Kenyon
• Ekta Khurana, M.D.
• Eyob G Kidane, PA-C
• Lena Knight
• Jackie Kraai, RN00120978

• Registered Nurse First Assistant in Pasco, WA
• Providers in Pasco, WA by specialty
• Registered Nurse First Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.