Active NPI
Kelly Kallstrom Haddad, CNA
- Personal Care Attendant
- Lakeland, FL
National Provider Identifier
1760334205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- CNA430647
- Practice address
- 6416 Odom Rd
Lakeland, FL 33809-4120 - Phone
- (314) 800-5619
- Fax
- (314) 800-5619
- NPI assigned
- Feb 9, 2026
- 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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | CNA430647 | FL | Primary |
Addresses
Primary practice location
6416 Odom Rd
Lakeland, FL 33809-4120
Mailing address
6416 Odom Rd
Lakeland, FL 33809-4120
Phone (314) 800-5619
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNA430647 | FL | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1770595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770595200000",
"number": "1760334205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6416 ODOM RD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338094120",
"telephone_number": "314-800-5619",
"fax_number": "314-800-5619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6416 ODOM RD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338094120",
"telephone_number": "314-800-5619",
"fax_number": "314-800-5619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HADDAD",
"first_name": "KELLY",
"middle_name": "KALLSTROM",
"credential": "CNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-09",
"last_updated": "2026-02-09",
"certification_date": "2026-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "FL",
"license": "CNA430647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.