KELLY LYNN PIETAN (NPI# 1336388982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336388982 |
| Entity Type | Individual |
| Full Name | KELLY LYNN PIETAN |
| Credential | CRNA |
| Practice Address |
655 W 8th St Ufjax - Dept. of Anesthesiology Jacksonville FL 32209-6511 |
| Mailing Address |
Po Box 44008 Ufjp - Provider Enrollment Jacksonville FL 32231-4008 |
| Practice Telephone | 9042444195 |
| Practice Fax Number | 9042444908 |
| Mailing Telephone | 9042443199 |
| Mailing Fax Number | 9042443425 |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2015-12-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | ARNP9184815 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 602083230C | 05 | |
| FL | 0007980-00 | 05 | |
| GA | 602083230B | 05 | |
| GA | 602083230A | 05 |
| Street Address |
655 W 8TH ST UFJAX - DEPT. OF ANESTHESIOLOGY |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32209-6511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770586828 | Ghaith Mitri | Internal Medicine | 655 W 8th St, Ufjp Rheumatology Dept., Jacksonville, FL 32209-6511 | 2005-05-23 |
| 1386242253 | Keivan Tavakoli | General Practice | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-10-13 |
| 1013522473 | Jacquelyn Hill | Nurse Practitioner | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-09-12 |
| 1346854346 | Whitney O'brien | Dietitian, Registered | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-09-07 |
| 1548873318 | Kelly Huston | Pharmacist | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-08-31 |
| 1427669423 | Dianna Louise Tompkins | Registered Nurse | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-08-12 |
| 1235748021 | Treasure Victoria Bright | Pharmacist | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-07-28 |
| 1003424656 | Christopher Fuller | Physical Therapist | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-07-20 |
| 1922616051 | Katie Reel | Pharmacist | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-07-15 |
| 1437767688 | Bethany Pope | Pharmacist | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710506183 | Hayley M Shade | Student in an Organized Health Care Education/Training Program | 655 8th St. W., 4th Floor, Lrc 653-1 West 8th Street, L18, Jacksonville, FL 32209 | 2020-04-15 |
| 1407484629 | Micah Christine Turpeau | Student in an Organized Health Care Education/Training Program | 580 W. 8th St., Tower II, Suite 6005, Jacksonville, FL 32209 | 2020-04-01 |
| 1730716366 | Nikki Javia | Student in an Organized Health Care Education/Training Program | 653-1 W 8th St, Fl 4, Lrc Box L16, Jacksonville, FL 32209 | 2020-03-24 |
| 1336776061 | Samuel Kamoroff | Student in an Organized Health Care Education/Training Program | 653-1 West 8th Street, 4th Floor, Lrc Box L16, Jacksonville, FL 32209 | 2020-03-24 |
| 1376194092 | Donald Wayne Johnson Jr. | Pharmacist | Uf Health Jacksonville, 655 West 8th Street, Jacksonville, FL 32209 | 2019-09-24 |
| 1871141838 | Anton Daran Armstrong | Counselor | 921 N. Davis St. Bldg. B, Suite 350, Jacksonville, FL 32209 | 2019-09-03 |
| 1295296499 | Christian King | Student in an Organized Health Care Education/Training Program | 580 W. 8th St., Tower II, Suite 6005, Jacksonville, FL 32209 | 2019-03-29 |
| 1013478403 | David William Barton | Orthopaedic Surgery | 655 W 8th St, Box C-126, Jacksonville, FL 32209 | 2019-03-27 |
| 1912497108 | Lisa Jordan | Adult Companion | 1515 W 31st St, Jacksonville, FL 32209 | 2018-05-14 |
| 1275020968 | Eloisa Anne Ello-esma | Nurse Practitioner | W. 8th Street, Jacksonville, FL 32209 | 2018-04-18 |
| Find all providers in zip 32209 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992275572 | William Lundgren | Nurse Anesthetist, Certified Registered | 3625 University Blvd South, Jacksonville, FL 32258 | 2018-11-27 |
| 1215436423 | Jenitre Shavonne Moore | Nurse Anesthetist, Certified Registered | 5885 Edenfield Rd Apt L32, Jacksonville, FL 32277-1203 | 2018-02-03 |
| 1811402407 | Aubrey Crowe | Nurse Anesthetist, Certified Registered | 1415 Windsor Pl, Jacksonville, FL 32205-7910 | 2017-12-05 |
| 1497294516 | Megan Powell | Nurse Anesthetist, Certified Registered | 13003 Springs Manor Dr, Jacksonville, FL 32258-8437 | 2017-02-22 |
| 1679017123 | Catherine Scanlon | Nurse Anesthetist, Certified Registered | 4635 Charles Bennett Dr, Jacksonville, FL 32225-1301 | 2016-12-16 |
| 1720444623 | Katrina Canady | Nurse Anesthetist, Certified Registered | 13609 Devan Lee Dr E, Jacksonville, FL 32226-5810 | 2016-01-07 |
| 1104291822 | Jenny Kambel | Nurse Anesthetist, Certified Registered | 13856 Herons Landing Way, Apt 5, Jacksonville, FL 32224-6065 | 2015-12-07 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1437540234 | Catherine Simms | Nurse Anesthetist, Certified Registered | 400 Health Park Boulevard St., Jacksonville, FL 32086 | 2015-02-16 |
| 1699164889 | Valerie Wolff Aquino | Nurse Anesthetist, Certified Registered | 8638 Stanmoor Ct, Jacksonville, FL 32244-7160 | 2015-01-12 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32209 |
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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.