NATALIE NICOLE KELLETT (NPI# 1376995159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376995159 |
| Entity Type | Individual |
| Full Name | NATALIE NICOLE KELLETT |
| Practice Address |
120 Heywood Avenue Suite 200 Spartanburg SC 29302 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8645739595 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2020-01-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
20315 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE PTAN | SC88064722 | 01 |
| SC | MEDICARE PTAN | SC88066121 | 01 |
| SC | MEDICARE PIN | SC88066084 | 01 |
| SC | MEDICARE PIN | SCA009J577 | 01 |
| SC | NP3964 | 05 | |
| SC | MEDICARE PTAN | SC88066067 | 01 |
| Street Address |
120 HEYWOOD AVENUE SUITE 200 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226476 | Healthstat Inc Grace Management | Preventive Medicine | 951 South Pin Street, Suite 200, Spartanburg, SC 29302 | 2020-08-18 |
| 1467978304 | Katherine Tomes | Speech-Language Pathologist | 355 Cedar Springs Road, Spartanburg, SC 29302 | 2017-08-22 |
| 1396291167 | Brent Timothy Smith | Specialist | 151 Ribault Street Suite 200, Spartanburg, SC 29302 | 2016-08-31 |
| 1902273808 | Tamieka Latrell Alston-gibson | Nurse Practitioner | 101 North Pine Street, Suite 210, Spartanburg, SC 29302 | 2015-08-26 |
| 1700209905 | Robert W Wyatt | Pharmacist | 203 Cedar Springs Rd, Spartanburg, SC 29302 | 2014-01-24 |
| 1952735748 | James Sidney Fulmer Sr. | Obstetrics & Gynecology | 167 Ivy Court, Spartanburg, SC 29302 | 2013-08-28 |
| 1053651828 | Jennifer Geddes Hall | Counselor | 101 N Pine St Ste 210, Spartanburg, SC 29302 | 2013-02-15 |
| 1487875514 | Park Place Spartanburg | Assisted Living Facility | 2720 Country Clud Road, Spartanburg, SC 29302 | 2007-05-02 |
| 1740304401 | Leon Derek Herring | Dentist | 270 Cedar Spring Rd, Spartanburg, SC 29302 | 2007-03-19 |
| 1306973672 | Julian Williams | Internal Medicine | 319 N Pine St, Spartanburg, SC 29302 | 2007-02-27 |
| Find all providers in zip 29302 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231625 | Trisha Slaughter | Nurse Practitioner | 610 Adelaide Dr, Spartanburg, SC 29301-3231 | 2020-06-30 |
| 1891323457 | Jonathan Douglas Tester | Nurse Practitioner | 220 Police Club Rd, Spartanburg, SC 29303-3402 | 2020-03-30 |
| 1215455944 | Jasmine Marie Gregory | Nurse Practitioner | 300 E Blackstock Rd Ste E, Spartanburg, SC 29301-3787 | 2017-09-01 |
| 1730600396 | Stephanie Cannon | Nurse Practitioner | 100 E Wood St Ste 202, Spartanburg, SC 29303-3058 | 2017-07-03 |
| 1538698030 | Deborah Temples Anderson | Nurse Practitioner | 11 Doctors Park Dr Ste 220, Spartanburg, SC 29307-1008 | 2017-06-08 |
| 1285181990 | Faustina Baafour Evans | Nurse Practitioner | 1855 E Main St Ste 21a, Spartanburg, SC 29307-2327 | 2016-09-10 |
| 1013372390 | Erin Lavette Farr | Nurse Practitioner | 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 | 2015-12-30 |
| 1992170807 | Jaime Bright | Nurse Practitioner | 301 E Wood St, Spartanburg, SC 29303-3020 | 2015-12-02 |
| 1902273808 | Tamieka Latrell Alston-gibson | Nurse Practitioner | 101 North Pine Street, Suite 210, Spartanburg, SC 29302 | 2015-08-26 |
| 1922481712 | Sean Patrick Walsh | Nurse Practitioner | 2030 North Church Pl, Spartanburg, SC 29303-2799 | 2015-06-30 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29302 |
Please comment or provide details below to improve the information on NATALIE NICOLE KELLETT.
| 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.