KETTELIE HENRY (NPI# 1013576511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013576511 |
| Entity Type | Individual |
| Full Name | KETTELIE HENRY |
| Credential | ARNP |
| Practice Address |
3800 S Ocean Dr Ste 209 Hollywood FL 33019-2915 |
| Practice Telephone | 8772268874 |
| Practice Fax Number | 8773664776 |
| Mailing Telephone | 8002268874 |
| Mailing Fax Number | 8773664776 |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2020-06-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN11002547 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 929 Imperial Lake Rd, West Palm Beach, FL 334131075 | 5612542352 |
| Street Address |
3800 S OCEAN DR STE 209 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33019-2915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568428266 | Steven Magilen | Surgery | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019 | 2006-04-22 |
| 1164056420 | Victoria Howell | Physician Assistant | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019-2915 | 2020-02-26 |
| 1215592415 | Amna-marie Mohammad Ciantar | Nurse Practitioner | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019-2915 | 2019-05-03 |
| 1942865324 | Sarah Willey | Nurse Practitioner | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019-2915 | 2019-05-01 |
| 1457825390 | Clifton Neal Amos | Physician Assistant | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019-2915 | 2019-01-14 |
| 1346718947 | Natacha Blanchet | Nurse Practitioner | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019-2915 | 2018-11-13 |
| 1427558329 | Amanda Nicholas Jones | Nurse Practitioner | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019-2915 | 2018-02-16 |
| 1861906612 | Morris Anthony Chemell | Pain Medicine | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019-2915 | 2017-11-30 |
| 1356852123 | Qsm-ga, Inc. | Nurse Practitioner | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019-2915 | 2017-10-19 |
| 1932658226 | April Lynn Scata-penny | Nurse Practitioner | 3800 S Ocean Dr Ste 209, Hollywood, FL 33019-2915 | 2016-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669868469 | Francine Safdeye | Occupational Therapist | 1201 S Ocean Dr. #1102s, Hollywood, FL 33019 | 2015-04-09 |
| 1932507217 | Alina Benin | Chiropractor | 2201 S. Ocean Dr. #801, Hollywood, FL 33019 | 2014-12-18 |
| 1568745610 | Ali Farrokhi | Dentist | 3000 S. Ocean Dr, Apt. # 1204, Hollywood, FL 33019 | 2011-09-26 |
| 1063706356 | Ann E Bivona | Registered Nurse | 3725 South Ocean Drive #1612, Hollywood, FL 33019 | 2011-06-03 |
| 1114180593 | Jeffrey A Levy Md Inc | Internal Medicine | 1600 Diplomat Parkway, Hollywood, FL 33019 | 2008-07-07 |
| 1700063443 | Wendy Gentile Sosa | Contractor | 3505 S. Ocean Drive, 1209, Hollywood, FL 33019 | 2008-01-24 |
| 1366598294 | Eduard Kaplan | Specialist/Technologist, Other | 1571 Yello Heart Way, Hollywood, FL 33019 | 2007-01-25 |
| 1235236712 | Florida Family Options, Inc. | Marriage & Family Therapist | 2101 S. Ocean Drive, Suite 2103, Hollywood, FL 33019 | 2006-09-19 |
| 1003919424 | Jessica L. Vera | Counselor | 1060 Oysterwood St, Hollywood, FL 33019 | 2006-09-07 |
| 1164614939 | Louis Richard Didonato | Radiology | 6001 N Ocean Dr, Apt 1206, Hollywood, FL 33019 | 2007-08-15 |
| Find all providers in zip 33019 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235739897 | Vanessa Arias | Nurse Practitioner | 931 S Park Rd Apt 207, Hollywood, FL 33021-8762 | 2020-10-31 |
| 1659979656 | Hendy Aubourg | Nurse Practitioner | 6940 Tyler St, Hollywood, FL 33024-7456 | 2020-10-12 |
| 1811509920 | Cynthia Remy | Nurse Practitioner | 11178 Mainsail Dr, Hollywood, FL 33026-4726 | 2020-08-19 |
| 1487264040 | Jorge Rolando Remon | Nurse Practitioner | 6230 Garfield St, Hollywood, FL 33024-5943 | 2020-08-07 |
| 1922618115 | Alba M Beltran | Nurse Practitioner | 7361 Cleveland St, Hollywood, FL 33024-5463 | 2020-08-03 |
| 1588280630 | Jackelyn Mi Bhattarai | Nurse Practitioner | 11018 Nashville Dr, Hollywood, FL 33026-4966 | 2020-06-24 |
| 1194349308 | Bethany Laquell Ellis | Nurse Practitioner | 210 S Federal Hwy Ste 300, Hollywood, FL 33020-6811 | 2020-06-03 |
| 1255951026 | Nicole Blum | Nurse Practitioner | 4712 Arthur St, Hollywood, FL 33021-4737 | 2020-04-22 |
| 1497383103 | Vanessa D King-smith | Nurse Practitioner | 6660 Meade St, Hollywood, FL 33024-1914 | 2020-03-29 |
| 1538793039 | Lyudmyla Tymtsyas | Nurse Practitioner | 4200 Hillcrest Dr Apt 304, Hollywood, FL 33021-7900 | 2020-02-24 |
| Find all providers in HOLLYWOOD | ||||
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| 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.