MRS. KELLY LYNNE BROEKHOF (NPI# 1477597680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477597680 |
| Entity Type | Individual |
| Full Name | MRS. KELLY LYNNE BROEKHOF |
| Credential | BSN |
| Practice Address |
Bldg 2104 Massey Ave Naval Station Mayport Jacksonville FL 32222 |
| Mailing Address |
644 Oriskany St Jacksonville FL 32227-1712 |
| Practice Telephone | 9042704293 |
| Mailing Telephone | 9043729141 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WC0400X |
Registered Nurse Specialization: Case Management |
RN 45281 | HI | Nursing Service Providers |
| Street Address |
BLDG 2104 MASSEY AVE NAVAL STATION MAYPORT |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427690353 | Emergency Physicians Inc | Emergency Medicine | 9868 Family Place, Jacksonville, FL 32222 | 2019-10-11 |
| 1053874578 | Silver Linings Community Care, LLC. | Home Health Aide | 250 Cherry Ridge #1435, Jacksonville, FL 32222 | 2019-04-11 |
| 1588144802 | Fleming Total Support Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6760 Portofina Ct, Jacksonville, FL 32222 | 2018-08-16 |
| 1447736293 | Phyllis N Parrish | Home Health Aide | 10506 Innisbrook Dr, Jacksonville, FL 32222 | 2018-07-16 |
| 1851880793 | Keiarra Hendrick | Clinic/Center | 250 Cherry Ridge Dr Apt 1021, Jacksonville, FL 32222 | 2018-05-07 |
| 1427573310 | Priority Love & Care, Inc. | Voluntary or Charitable | 7283 Old Middleburg Rd S, Jacksonville, FL 32222 | 2017-08-11 |
| 1801334834 | Stacey Nicole Harden | Nurse Practitioner | 9785 Corsshill Blvd, Suite 108, Jacksonville, FL 32222 | 2017-02-09 |
| 1184031841 | Andrew Todd Pinder | Family Medicine | 8355 Merchants Gate Drive, Jacksonville, FL 32222 | 2014-07-15 |
| 1538455142 | Ricky Wallace | Social Worker | 10512 Innisbrook Drive, Jacksonville, FL 32222 | 2011-06-22 |
| 1356883839 | Baptist Primary Care Inc | Family Medicine | 8355 Merchants Gate Dr, Jacksonville, FL 32222 | 2016-11-15 |
| Find all providers in zip 32222 | ||||
| Taxonomy Code | 163WC0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689274490 | Kimberly Bell | Registered Nurse | 8243 Garden View Ct, Jacksonville, FL 32256-7164 | 2020-10-30 |
| 1366938714 | Charlene Lavette Williams | Registered Nurse | 11307 Nettlebrook St E, Jacksonville, FL 32218-1006 | 2018-07-09 |
| 1366687634 | Mary Marlene Darragh | Registered Nurse | 123 Alabama Dr, Jacksonville, AR 72076-1002 | 2008-12-15 |
| 1538778683 | Kristen C Munroe | Registered Nurse | 12724 Gran Bay Pkwy W Ste 150, Jacksonville, FL 32258-9486 | 2020-07-24 |
| 1609108372 | Laree Pruitt Moody | Registered Nurse | 910 N Jefferson St, Jacksonville, FL 32209-6810 | 2010-02-05 |
| 1346475068 | Melana Andreu Smith | Registered Nurse | 910 N Jefferson St, Jacksonville, FL 32209-6810 | 2009-05-26 |
| 1811185465 | Valerie Anne Beasley | Registered Nurse | 910 N Jefferson St, Jacksonville, FL 32209-6810 | 2007-10-09 |
| 1629266283 | Laci Adrianne Holmes | Registered Nurse | 910 N Jefferson St, Jacksonville, FL 32209-6810 | 2007-10-09 |
| 1144383019 | Debra Warren Reiley | Registered Nurse | 910 N Jefferson St, Jacksonville, FL 32209-6810 | 2006-12-19 |
| 1518020460 | Linda Lou Garcia | Registered Nurse | 515 West 6th Street, Center for Women and Children, Jacksonville, FL 32206 | 2006-12-19 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32222 |
Please comment or provide details below to improve the information on MRS. KELLY LYNNE BROEKHOF.
| 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.