Mary Jo Kelly, DNP, ARNP, ACNS-BC

Primary specialty

Critical Care Medicine Clinical Nurse SpecialistTaxonomy code 364SC0200X

License

AP60676450 Issued in WA

Practice address

500 17TH Ave
Seattle, WA 98122-5711

Phone

(206) 353-6686

NPI assigned

Aug 21, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1659155877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10811 11TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256401",
            "telephone_number": "206-353-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 17TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225711",
            "telephone_number": "206-353-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARY JO",
        "credential": "DNP, ARNP, ACNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "WA",
            "license": "AP60676450",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "WA",
            "license": "AP60676450",
            "primary": false
        },
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "WA",
            "license": "AP60676450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Kelly, RN
• Kimberly Ann Kelly, N.D.
• Kristen Lynn Kelly, MD
• Marcia Anita Kelly, MSW
• Margaret Kelly, LMHC
• Mary Sturgeleski Kelly, PHARM.D.
• Michael Kelly
• Michael R Kelly, MD
• Milissa Kelly
• Myra Eliece Kelly

• Clinical Nurse Specialist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Nurse Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.