Angela Marie Kelly

Individual provider Active NPI Home Health Registered Nurse · Freeport, FL

NPI 1700775574 · NPPES record last updated Jun 28, 2025

Key facts

NPI
1700775574
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
RN9497928 (FL)
Practice address
164 Eagles Nest Dr
Freeport, FL 32439-2392
Phone
(815) 347-3728
NPI assigned
Jun 28, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN9497928FLMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN9497928 FL Yes

Addresses

Primary practice location

164 Eagles Nest Dr
Freeport, FL 32439-2392

Mailing address

164 Eagles Nest Dr
Freeport, FL 32439-2392

Other providers in Freeport, FL

All providers in Freeport, FL · Home Health Registered Nurse in Florida

Sources for this page

Verify at the official NPI Registry.