Kelly Dee Vancleve

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1700477 Issued in MN

Practice address

18255 Icon CT
Lakeville, MN 55044-2276

Phone

(612) 384-9408

NPI assigned

Dec 10, 2020

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": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1881290120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18255 ICON CT",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550442276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18255 ICON CT",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550442276",
            "telephone_number": "612-384-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCLEVE",
        "first_name": "KELLY",
        "middle_name": "DEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MN",
            "license": "1700477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Ann Ungar, PA-C
• Upright Health PLLC
• Ethan T Urtel
• Shaida Vafaei, MA
• Paige Van Lanen, COTA/L
• Shana Vande Zande
• Christopher Vandergriff, DPT
• Melissa Catherine Vandermause, PHARMD
• Pearl Pajdawb Vang
• Cynthia Susanna Vansickler, D.C.

• All providers in Lakeville, MN
• Acute Care Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.