Individual provider Active NPI

Kellie Anne Harkness, MSN, APRN

  • Family Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1720541683
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61024006 Issued in WA
Practice address
9040 Jackson Ave
Tacoma, WA 98431-8142
Phone
(253) 477-5149
Fax
(253) 477-5143
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 115697 KS
Family Nurse Practitioner 363LF0000X AP61024006 WA Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-8142

Mailing address

9040 Jackson Ave
Tacoma, WA 98431-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200309000697 WA Practitioner - Nurse Practitioner 4284062142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
115697KSMDRegistered Nurse
AP61024006WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Littlerock Family Medicine, P.S. PastSince Oct 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1720541683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984318142",
            "telephone_number": "253-477-5149",
            "fax_number": "253-477-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKNESS",
        "first_name": "KELLIE",
        "middle_name": "ANNE",
        "credential": "MSN, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "115697",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61024006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.