KELLY WAKEFIELD (NPI# 1164073557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164073557 |
| Entity Type | Individual |
| Full Name | KELLY WAKEFIELD |
| Credential | APRN.CNP |
| Practice Address |
2700 Lafayette St Fort Wayne IN 46806-1100 |
| Practice Telephone | 2607024404 |
| Practice Fax Number | 2607443006 |
| Mailing Telephone | 2607024404 |
| Mailing Fax Number | 2607443006 |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2020-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
71009784A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2231 Wales Ave, Lima, OH 458053447 | 4192346552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790024461 | Kelly Ann Wakefield | Physical Therapy Assistant | 1 Kaylor Cir, Frostburg, MD 21532-2009 | 2013-01-31 |
| Street Address |
2700 LAFAYETTE ST |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46806-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053376186 | Rebecca Konkin | Nurse Practitioner | 2700 Lafayette St, Ste B-10, Fort Wayne, IN 46806-1100 | 2006-04-20 |
| 1316556848 | Alliance Health Centers, Inc. | Nurse Practitioner | 2700 Lafayette St, Fort Wayne, IN 46806-1100 | 2020-07-30 |
| 1003193814 | Lafayette Foot & Ankle LLC | Podiatrist | 2700 Lafayette St, Suite 100, Fort Wayne, IN 46806-1100 | 2011-11-08 |
| 1295838365 | Benny Fair Jr. | Podiatrist | 2700 Lafayette St, Suite 120, Fort Wayne, IN 46806-1100 | 2006-09-06 |
| 1053377606 | Jennifer Shambaugh | Nurse Practitioner | 2700 Lafayette St, Ste B-10, Fort Wayne, IN 46806-1100 | 2006-04-24 |
| 1740246651 | Sharon Heaton | Nurse Practitioner | 2700 Lafayette St, Ste 110, Fort Wayne, IN 46806-1100 | 2006-04-21 |
| 1386600120 | Rachael F. Rogers | Physician Assistant | 2700 Lafayette St, Ste 110, Fort Wayne, IN 46806-1100 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841574829 | Daniel E Purvis Jr. | Pharmacist | 222 E Pettit Avenue, Fort Wayne, IN 46806 | 2011-10-07 |
| 1558645754 | Logan M Franke | Pharmacist | 222 E Pettit Ave, Fort Wayne, IN 46806 | 2011-10-06 |
| 1356513725 | Seazoned Med Transportation Service | Non-emergency Medical Transport (VAN) | 2809 Smith Street, Fort Wayne, IN 46806 | 2008-03-26 |
| 1376711267 | Hector F Perez Md PC | Family Medicine | 5717 So Anthony, Ste 500, Fort Wayne, IN 46806 | 2008-02-14 |
| 1326249376 | Purdue University | Dentist | 2700 South Lafayette Street, Fort Wayne, IN 46806 | 2007-05-29 |
| 1174657480 | Robert Anthony Ford | Case Manager/Care Coordinator | 525 Oxford St., Fort Wayne, IN 46806 | 2007-03-16 |
| 1508069972 | Indiana University | Clinic/Center | 2700 South Lafayette Street, Fort Wayne, IN 46806 | 2007-06-06 |
| 1669622403 | Sally J Hartman | Nurse Practitioner | 2700 S Lafayette St, Suite 200, Fort Wayne, IN 46806-1100 | 2008-09-30 |
| 1003099441 | Lafayette Foot and Ankle Clinic | Podiatrist | 2700 Lafayette St Ste 230, Fort Wayne, IN 46806-1100 | 2007-12-07 |
| 1033259197 | V E Butler and Associates PC | Pharmacist | 2700 S. Lafayette St, Communitycare Pharmacy, Fort Wayne, IN 46806-1100 | 2007-02-07 |
| Find all providers in zip 46806 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588722268 | Emmalou Dinken | Nurse Practitioner | 3914 W Jefferson Blvd, Fort Wayne, IN 46804 | 2006-12-05 |
| 1013268739 | Cara E Walker | Nurse Practitioner | 11123 Parkview Plaza Dr, Suite 101, Fort Wayne, IN 46845-1707 | 2012-09-20 |
| 1891841664 | Cynthia Sue Mintch | Nurse Practitioner | 3914 W Jefferson Blvd, Fort Wayne, IN 46804-6812 | 2007-01-26 |
| 1063522282 | Ludmila Roebel | Nurse Practitioner | 1717 S Calhoun St, Fort Wayne, IN 46802-5257 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265077572 | Tara Lynette Flanagan | Nurse Practitioner | 2629 Waterfront Parkway East Dr Ste 375, Indianapolis, IN 46214-2026 | 2019-11-11 |
| 1184266827 | Bethany L. Odero | Nurse Practitioner | 550 University Blvd Ste 2041, Indianapolis, IN 46202-5149 | 2019-10-15 |
| 1487201166 | Bonnie Wellman | Nurse Practitioner | 1403 Allison Blvd, Auburn, IN 46706-3205 | 2019-08-19 |
| 1396285656 | Wendy K Carter | Nurse Practitioner | 720 Eskenazi Avenue, Suite F2-600, Eskenazi Health, Indianapolis, IN 46202 | 2017-03-06 |
| 1972042463 | Deborah Jean Dilk | Nurse Practitioner | 8067 N Oliver Ln, Dupont, IN 47231-9565 | 2017-02-16 |
| 1386183937 | Juanita Lock | Nurse Practitioner | 10051 N State Road 62, Canaan, IN 47224-9759 | 2017-02-15 |
| 1073975546 | Margaret Cockshott | Nurse Practitioner | 640 Eskenazi Ave, Fifth Third Bank Building, Indianapolis, IN 46202-5173 | 2016-03-24 |
| 1972859452 | Courtney B. Cortez | Nurse Practitioner | 12400 N Meridian Ste 100, Suite 500, Indianapolis, IN 46250 | 2012-08-02 |
| 1699038430 | Aimee Leigh Anderson | Nurse Practitioner | 7120 Clearvista Dr Ste 3200, Indianapolis, IN 46256 | 2012-06-18 |
| 1104101047 | Amanda Jo Phelps | Nurse Practitioner | 4199 Gateway Blvd Ste 3500, Newburgh, IN 47630-7909 | 2011-10-11 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46806 |
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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.