STACEY RACHELLE KELLY (NPI# 1205478021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205478021 |
| Entity Type | Individual |
| Full Name | STACEY RACHELLE KELLY |
| Credential | FNP |
| Practice Address |
3506 21st St 507 Lubbock TX 79410-1105 |
| Mailing Address |
2215 Nashville Avenue Lubbock TX 79410-1106 |
| Practice Telephone | 8067254800 |
| Mailing Telephone | 8067255844 |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2019-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP143497 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760896708 | Stacey Kelly | Counselor | 7751 Hood St, 7751 Hood St, Hollywood, FL 33024-2525 | 2014-06-18 |
| 1669936142 | Stacey Elizabeth Kelly | Nurse Practitioner | 3400 Spruce St, 4 Silverstein, Philadelphia, PA 19104-4238 | 2019-01-29 |
| 1588912018 | Stacey Lynne Kelly | Social Worker | 312 Locust St, Akron, OH 44302-1801 | 2012-08-15 |
| 1881671634 | Stacey Ann Kelly | Nurse Practitioner | 915 W Monroe St Ste 200, Jacksonville, FL 32204-1177 | 2005-12-22 |
| Street Address |
3506 21ST ST 507 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79410-1105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878267 | Covenant Medical Center | Clinic/Center | 3615 19th, Lifestyle Centre-east Parking Garage, Lubbock, TX 79410 | 2020-07-20 |
| 1669038626 | Hub City Anesthesia | Nurse Anesthetist, Certified Registered | 3416 22nd Street, Lubbock, TX 79410 | 2019-05-15 |
| 1912447418 | Lubbock Surgery Center, LLC | Clinic/Center | 3416 22nd St, Lubbock, TX 79410 | 2017-03-02 |
| 1871032698 | Lezlee Berry | Pharmacist | 3615 19th Street, Lubbock, TX 79410 | 2017-02-13 |
| 1376914101 | Matthew Cotton | Nurse Practitioner | 2424 Quaker Ave, Lubbock, TX 79410 | 2015-10-20 |
| 1841534864 | Frank Nwabugwu | Pharmacist | 4120 34th Street, Lubbock, TX 79410 | 2012-11-15 |
| 1689954794 | Dharmendra Kumar | Pediatrics | Covenant Children's Hospital, 4000 24th Street, Lubbock, TX 79410 | 2011-08-19 |
| 1518277177 | T.r.m. Rao, M.d., P.a. | Colon & Rectal Surgery | 3809 22nd Street, Suite C, Lubbock, TX 79410 | 2010-10-18 |
| 1700196672 | Hanford Consultations P.a. | Family Medicine | 4000 22nd Place Suite 100, Lubbock, TX 79410 | 2010-10-13 |
| 1336452598 | Amanda Collins | Specialist | 4801 34th Street, Lubbock, TX 79410 | 2010-07-16 |
| Find all providers in zip 79410 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911859 | Amber Marie Bowman | Nurse Practitioner | 5106 59th St, Lubbock, TX 79414-4312 | 2020-10-29 |
| 1609475219 | Jonathan-michael Aaron Sisson | Nurse Practitioner | 7421 104th St, Lubbock, TX 79424-6079 | 2020-10-23 |
| 1174134753 | Rebecca Stephanie Castillo | Nurse Practitioner | 5528 109th St, Lubbock, TX 79424-7680 | 2020-08-16 |
| 1508487398 | Mark Angelo Padolina | Nurse Practitioner | 1101 Oshkosh Ave, Lubbock, TX 79416-3810 | 2020-05-03 |
| 1841826724 | Leticia Luna Flores Cooper | Nurse Practitioner | 2511 60th St, Lubbock, TX 79413-5641 | 2020-03-23 |
| 1952931693 | Camella Dawn Ladd | Nurse Practitioner | 1307 Martin Luther King Blvd, Lubbock, TX 79403-5329 | 2020-01-22 |
| 1962042598 | Wendy Geraldine Avalos | Nurse Practitioner | 9304 Primrose Ave, Lubbock, TX 79424-6799 | 2020-01-11 |
| 1619516325 | Jessica Krueger | Nurse Practitioner | 5502 103rd St, Lubbock, TX 79424-6417 | 2019-12-27 |
| 1417596438 | Alicia Michelle Powell | Nurse Practitioner | 6102 82nd St Ste 14, Lubbock, TX 79424-0840 | 2019-12-23 |
| 1376181537 | Ashley Nicole White | Nurse Practitioner | 5614 100th St, Lubbock, TX 79424-6268 | 2019-12-18 |
| Find all providers in LUBBOCK | ||||
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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.