Kristin Lee Kelley

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN5235826 Issued in FL

Practice address

3928 S Nova Rd
Port Orange, FL 32127-4911

Phone

(386) 822-9941

Fax

(386) 788-4519

NPI assigned

Nov 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1841955853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 CLYDE MORRIS BLVD APT 603",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321298202",
            "telephone_number": "303-564-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3928 S NOVA RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274911",
            "telephone_number": "386-822-9941",
            "fax_number": "386-788-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KRISTIN",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5235826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Kavanagh
• Tanya Kays
• Tracee Keefer
• Danielle Kehoe
• Phillip Jeffery Kelemen, DDS
• Mark David Kendrick, M.D.
• Saniqusha Santana Kennedy, RBT
• Ashley Kephart
• Brandy Lee Kern, D.C.
• Samantha Kerstetter

• Licensed Practical Nurse in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.