Individual provider Active NPI

Kelly Sue Brannan, RN

  • Emergency Registered Nurse
  • Grantsville, WV
National Provider Identifier
1720676646
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
66361 Issued in WV
Practice address
186 Hospital Dr
Grantsville, WV 26147-7100
Phone
(304) 354-9244
NPI assigned
Jan 6, 2021
Last updated
Jan 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 66361 WV Primary

Addresses

Primary practice location

186 Hospital Dr
Grantsville, WV 26147-7100

Mailing address

4108 9TH Ave
Parkersburg, WV 26101-6516
Phone (304) 834-2994

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
66361WVMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1720676646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 9TH AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261016516",
            "telephone_number": "304-834-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 HOSPITAL DR",
            "city": "GRANTSVILLE",
            "state": "WV",
            "postal_code": "261477100",
            "telephone_number": "304-354-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNAN",
        "first_name": "KELLY",
        "middle_name": "SUE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "WV",
            "license": "66361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grantsville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.