Active NPI
Deborah Kelly, MSN, RN, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Las Cruces, NM
National Provider Identifier
1669790010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- CNP-01627
- Practice address
- 100 W Griggs Ave
Las Cruces, NM 88001-1234 - Phone
- (575) 647-2800
- Fax
- (575) 647-2898
- NPI assigned
- May 10, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | CNP-01627 | NM | Primary |
Addresses
Primary practice location
100 W Griggs Ave
Las Cruces, NM 88001-1234
Mailing address
385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CNP-01627 | Other | NM | CERTIFIED NURSE PRACTITIONER LICENSE NUMBER |
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)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP-01627 | NM | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447200000000",
"number": "1669790010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "385 CALLE DE ALEGRA STE A",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053423",
"telephone_number": "575-526-1105",
"fax_number": "575-524-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W GRIGGS AVE",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880011234",
"telephone_number": "575-647-2800",
"fax_number": "575-647-2898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "DEBORAH",
"credential": "MSN, RN, PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-10",
"last_updated": "2015-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NM",
"license": "CNP-01627",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED NURSE PRACTITIONER LICENSE NUMBER",
"identifier": "CNP-01627",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.