Jacqueline Ann Kelly, RN
Individual provider Active NPI Registered Nurse · Mohall, ND
NPI 1972259505 · NPPES record last updated Feb 22, 2022
Key facts
- NPI
- 1972259505
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 33918 (ZZ)
- Practice address
- 206 3Rd St NW
Mohall, ND 58761-4105 - Phone
- (306) 540-7407
- NPI assigned
- Feb 22, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33918 | ZZ | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 33918 | ZZ | Yes |
Addresses
Primary practice location
206 3Rd St NW
Mohall, ND 58761-4105
Mailing address
PO Box 811
Mohall, ND 58761-0811
Phone (306) 540-7407
Other names
- Jacqueline Ann Tisher
Other providers in Mohall, ND
- Virginia Jean Engh
- Kayla Fisher
- Rachel Hanson
- Paul Daniel Herigstad
- Vera Jones
- Jan Jessie McLean
- Mohall Ambulance Service
- Prairie Home and Health LLC
- Renville County Social Services
- Peggy Ring
All providers in Mohall, ND · Registered Nurse in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.