KELLY KELLY (NPI# 1003228446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003228446 |
| Entity Type | Individual |
| Full Name | KELLY KELLY |
| Credential | N.P. |
| Practice Address |
4100 Covert Ave Evansville IN 47714-5559 |
| Practice Telephone | 8124769983 |
| Practice Fax Number | 8124376149 |
| Mailing Telephone | 8124769983 |
| Mailing Fax Number | 8124376149 |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71004900A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | INDIANA | 28184683A | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4480 N 1st Ave, Evansville, IN 477103622 | 8124251525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780979302 | Kelly Nelson Kelly | Pediatrics | 5841 S Maryland Ave # Mc6060, Chicago, IL 60637-1447 | 2011-06-11 |
| 1467952788 | Kelly Kelly | Counselor | 1515 Indianola Ave, Columbus, OH 43201-2118 | 2018-02-13 |
| 1295981561 | Kelly D Kelly | Social Worker | 1730 Prospect Ave, Kansas City, MO 64127-2544 | 2008-08-18 |
| 1043493919 | Kelly Lynn Kelly | Audiologist | 8254 Mayfield Rd, Suite #6, Chesterland, OH 44026-2593 | 2007-12-13 |
| Street Address |
4100 COVERT AVE |
| City | EVANSVILLE |
| State | IN |
| Zip Code | 47714-5559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467435099 | Mohammed S Adeel | Physical Medicine & Rehabilitation | 4100 Covert Ave, Evansville, IN 47714-5559 | 2005-11-29 |
| 1104215532 | Evan Hampton | Pharmacist | 4100 Covert Ave, Evansville, IN 47714-5559 | 2015-01-22 |
| 1609096015 | Meranda Dawn Makun | Physical Therapy Assistant | 4100 Covert Ave, Evansville, IN 47714-5559 | 2007-04-26 |
| 1326195215 | David Robertson | Psychiatry & Neurology | 4100 Covert Ave, Evansville, IN 47714-5559 | 2007-01-04 |
| 1871676692 | Marco A Zolezzi | Physical Medicine & Rehabilitation | 4100 Covert Ave, Evansville, IN 47714-5559 | 2006-10-23 |
| 1780783183 | Gregory G Ennis | Physical Medicine & Rehabilitation | 4100 Covert Ave, Evansville, IN 47714-5559 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922343490 | Mary Elizabeth Esche | Physical Therapist | 3701 Bellemead Ave, Evansville, IN 47714 | 2012-12-10 |
| 1346524006 | Cheryl Ann Blanford | Pharmacist | 2015 E Covert Ave, Evansville, IN 47714 | 2011-09-29 |
| 1235446014 | Angela Kay Bradford-heidorn | Counselor | 4601 Bayard Park Drive, Evansville, IN 47714 | 2010-09-01 |
| 1104131655 | Cynthia D Lewis | Nurse Practitioner | 3700 Washington Ave Ste 202, Evansville, IN 47714 | 2010-08-09 |
| 1033357363 | Sarah M Voelkel | Podiatrist | 3801 Bellemeade Ave Ste 110a, Evansville, IN 47714 | 2009-01-23 |
| 1346443892 | Shilpa D Gaitonde | Internal Medicine | 3801 Bellemeade Ave Ste 300, Evansville, IN 47714 | 2007-06-11 |
| 1437361516 | Oncology Hematology Associates of Southwest Indiana | Internal Medicine | 3801 Bellemeade Suite 110, Evansville, IN 47714 | 2007-05-03 |
| 1629105374 | Comprehensive Neurosurgical Specialists, LLC | Neurological Surgery | 801 St Mary's Drive, Suite 505 East, Evansville, IN 47714 | 2007-02-28 |
| 1447387949 | Emily Mills | Physical Therapy Assistant | 1800 Elmendorf Avenue, Evanville, IN 47714 | 2007-02-28 |
| 1023153194 | Glen Gilbert Millikan II | Pharmacist | 1550 S. Vann Ave, Evansville, IN 47714 | 2007-02-20 |
| Find all providers in zip 47714 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235763079 | Kandi M Weber | Nurse Practitioner | 4972 Lincoln Ave # Suits101, Evansville, IN 47715-7909 | 2020-03-02 |
| 1376195578 | Brittany Martin | Nurse Practitioner | 801 Saint Marys Dr Ste 505, Evansville, IN 47714-0511 | 2019-07-09 |
| 1306316633 | Peighton's Place LLC | Nurse Practitioner | 12100 Highway 41 N Ste 1, Evansville, IN 47725-7032 | 2018-11-29 |
| 1629558481 | Lyndsey Hansen | Nurse Practitioner | 710 S Green River Rd Ste 1, Evansville, IN 47715-4104 | 2018-08-20 |
| 1609363852 | Megan Ann Armstrong | Nurse Practitioner | 100 S Rosenberger Ave Ste B400, Evansville, IN 47712 | 2018-04-13 |
| 1689171589 | Sara Gayle Fergus | Nurse Practitioner | 2330 Lynch Rd Ste 200, Evansville, IN 47711-2909 | 2018-04-09 |
| 1295243236 | Marina Lee Melton Mcwilliams | Nurse Practitioner | 3700 Washington Ave Ste 1100, Evansville, IN 47714-0541 | 2018-01-11 |
| 1043688187 | Ashly Williams | Nurse Practitioner | 727 John St, Evansville, IN 47713-2754 | 2015-09-06 |
| 1952704439 | Pennie Bell | Nurse Practitioner | 100 S Rosenberger Ave Ste A200, Evansville, IN 47712-6505 | 2014-09-29 |
| 1427483999 | Deanna Lynne Plummer | Nurse Practitioner | 4480 First Avenue, Evansville, IN 47710 | 2013-09-03 |
| Find all providers in EVANSVILLE | ||||
| City | EVANSVILLE |
| Zip Code | 47714 |
Please comment or provide details below to improve the information on KELLY KELLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.