MRS. JARENA JAN KELLY (NPI# 1235246729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235246729 |
| Entity Type | Individual |
| Full Name | MRS. JARENA JAN KELLY |
| Other Name | JARENA J GIBSON |
| Credential | DNP,APRN-BC |
| Practice Address |
828 Oakwood Rd Charleston WV 25314-2077 |
| Mailing Address |
L-3539 Columbus OH 43260 |
| Practice Telephone | 3043464865 |
| Practice Fax Number | 3043464868 |
| Mailing Telephone | 3044144800 |
| Mailing Fax Number | 3044144801 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2016-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
41613 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | GROUP MEDICARE | B441 | 01 |
| WV | 3810023573 | 05 | |
| WV | GROUP MEDICAID | 3810024049 | 01 |
| Street Address |
828 OAKWOOD RD |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25314-2077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558409367 | Living Well Medical Center | Internal Medicine | 828 Oakwood Rd, Charleston, WV 25314-2010 | 2007-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033559 | Nancy Galvan | Technician | 4587 Kanawha State Forrest Dr., Charleston, WV 25314 | 2020-11-04 |
| 1093316424 | Emma Mccloud | Technician | 710 Colony Dr., Charleston, WV 25314 | 2020-11-03 |
| 1699376137 | Amanda Gail Evans | Technician | 11 Happy Hl, Charleston, WV 25314 | 2020-11-02 |
| 1457879074 | Samantha Pennington | Pharmacist | 1100 Fledderjohn Rd Kroger #785, Charleston, WV 25314 | 2017-09-04 |
| 1992180335 | John Anthony Palmer IIi | Dentist | 867 Oakwood Road, Charleston, WV 25314 | 2015-07-28 |
| 1285039727 | West Virginia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 885 Oakwood Rd., Charleston, WV 25314 | 2014-10-27 |
| 1386980381 | Miranda L Broyles | Nurse Practitioner | 3200 Maccorkle Avenue Southwest, Charleston, WV 25314 | 2012-12-19 |
| 1548482896 | Christina M. Arco, Phd Pllc | Psychologist | 1013 B Oakhurst Drive, Charleston, WV 25314 | 2007-05-03 |
| 1578780359 | S & W Meeks Inc | Eyewear Supplier (Equipment, not the service) | 426 Division Street, South Charleston, WV 25314 | 2007-04-20 |
| 1669511853 | Gregory Alan Simmerman | Audiologist | 1105 Fledderjohn Road, Charleston, WV 25314 | 2007-02-05 |
| Find all providers in zip 25314 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557737 | Diondra Johnson | Nurse Practitioner | 2327 Watchtower Ln, Charleston, SC 29414-7803 | 2020-10-27 |
| 1427656735 | Kisha Lanece James | Nurse Practitioner | 16 Red Mulberry Way Apt 3, Charleston, WV 25306-0107 | 2020-10-09 |
| 1043822216 | Amber Bagwell | Nurse Practitioner | 442 King St Fl 2, Charleston, SC 29403-6230 | 2020-08-19 |
| 1790396273 | Amanda Jo Grant | Nurse Practitioner | 2207 Seneca Dr, Charleston, IL 61920-3836 | 2020-08-10 |
| 1811514961 | Isabel Margarita Lemasters | Nurse Practitioner | 3226 Moonlight Dr, Charleston, SC 29414-8052 | 2020-07-05 |
| 1255954566 | Christina L. White | Nurse Practitioner | 1199 Persimmon Rd, Charleston, IL 61920 | 2020-05-20 |
| 1770123929 | Catherine A. Woods | Nurse Practitioner | 9313 Medical Plaza Dr Ste 310, Charleston, SC 29406-9197 | 2020-01-15 |
| 1104464999 | Brittany D Griffith | Nurse Practitioner | 830 Pennsylvania Ave Ste 402, Charleston, WV 25302-3390 | 2019-12-12 |
| 1437795747 | Brigitte Britt Huttemeyer | Nurse Practitioner | 678 Castle Pinckney Dr, Charleston, SC 29412 | 2019-11-21 |
| 1124660774 | Dennis Robert Moore | Nurse Practitioner | 4610 Kanawha Ave Sw Ste 302, Charleston, WV 25309-1367 | 2019-10-16 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25314 |
Please comment or provide details below to improve the information on MRS. JARENA JAN 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.