KELLEY LAVINE (NPI# 1477867455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477867455 |
| Entity Type | Individual |
| Full Name | KELLEY LAVINE |
| Other Name | KELLEY MOCKUS |
| Credential | APRN |
| Practice Address |
101 Dudley St Providence RI 02905-2401 |
| Mailing Address |
98 Lincoln Rd Sutton MA 01590-3716 |
| Practice Telephone | 4012741122 |
| Mailing Telephone | 5088653613 |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2019-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
APRN01247 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
CNPP37216 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
101 DUDLEY ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02905-2401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083613244 | Martin Keszler | Pediatrics | 101 Dudley St, Providence, RI 02905-2401 | 2005-07-20 |
| 1326647959 | Deborah Ruth Shaffer | Advanced Practice Midwife | 101 Dudley St, Providence, RI 02905-2401 | 2020-10-24 |
| 1104449891 | Women & Infants Hospital of Rhode Island | Clinical Medical Laboratory | 101 Dudley St, Providence, RI 02905-2401 | 2020-05-28 |
| 1235751959 | Katherine Mariah Crawford | Genetic Counselor, MS | 101 Dudley St, Providence, RI 02905-2401 | 2020-05-15 |
| 1265061089 | Cassie Laurine Hobbs | Student in an Organized Health Care Education/Training Program | 101 Dudley St, Providence, RI 02905-2401 | 2020-04-03 |
| 1336776343 | Ogechukwu Francisca Uwanaka | Obstetrics & Gynecology | 101 Dudley St, Providence, RI 02905-2401 | 2020-03-27 |
| 1841827193 | Patricia Giglio Ayers | Obstetrics & Gynecology | 101 Dudley St, Providence, RI 02905-2401 | 2020-03-26 |
| 1205463783 | Alicia Marina Youssef | Obstetrics & Gynecology | 101 Dudley St, Providence, RI 02905-2401 | 2020-03-25 |
| 1912534330 | Alicia Esther Hersey | Obstetrics & Gynecology | 101 Dudley St, Providence, RI 02905-2401 | 2020-03-25 |
| 1932736220 | Allan Bo Huang | Student in an Organized Health Care Education/Training Program | 101 Dudley St, Providence, RI 02905-2499 | 2020-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477100808 | Raisa Emilia Garcia-diaz | Counselor | 66 Pavilion Avenue, Providence, RI 02905 | 2019-08-21 |
| 1962976571 | Nike A. Kendall | Social Worker | Program In Women's Oncology, 101 Dudley Street, Providence, RI 02905 | 2019-01-16 |
| 1891265443 | Carolyn Te Young | Pathology | 1320 Narragansett Blvd, Cranston, RI 02905 | 2018-11-27 |
| 1417427071 | Julianne Elizabeth Houtchens | Dietitian, Registered | Adult Primary Care 245 Chapman Street, Providence, RI 02905 | 2018-11-27 |
| 1922577394 | Dilenia C Cruz | Health Educator | 335r Prairie Ave., Suite 2b, Providence, RI 02905 | 2018-11-15 |
| 1639653116 | Varina S. Gunn | Health Educator | 335r Prarie Ave., Suite 2b, Providence, RI 02905 | 2018-09-20 |
| 1427590421 | Cardea Healthcare LLC | In Home Supportive Care | 100 Pavilion Avenue, Suite 101, Providence, RI 02905 | 2016-11-08 |
| 1265884597 | Maxwell King | Physical Therapy Assistant | 48 Moorland Avenue, Cranston, RI 02905 | 2016-07-11 |
| 1346698024 | Samantha Lea Colli | Physician Assistant | 100 Dudley St Fl 3, Providence, RI 02905 | 2016-06-02 |
| 1346697448 | Amy Jean Simpson | Marriage & Family Therapist | 1981 Broad Street, Cranston, RI 02905 | 2016-05-18 |
| Find all providers in zip 02905 | ||||
| Taxonomy Code | 363LN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619375375 | Adrianna Durrant | Nurse Practitioner | 174 W 280 N, Providence, UT 84332-9772 | 2014-12-11 |
| 1992280911 | Jennifer Ann Sardella | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2401 | 2018-09-25 |
| 1447739628 | Allison Vale | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2401 | 2018-08-09 |
| 1255839247 | Briana Hawksley | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2401 | 2018-01-25 |
| 1982102018 | Laura Ann Moreau | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2401 | 2018-01-23 |
| 1548652233 | Stephanie Curtis | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2401 | 2015-03-04 |
| 1053716993 | Megan Auld | Nurse Practitioner | 101 Dudley Street, Women and Infants Hospital Dept of Pediatrics, Providence, RI 02905-0290 | 2014-11-04 |
| 1588905046 | Mary Ann Santos | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2401 | 2013-03-08 |
| 1689946170 | Colleen Griffin Mcsweeney | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2401 | 2012-01-31 |
| 1780987917 | Virginia Mccann | Nurse Practitioner | 101 Dudley St, Providence, RI 02905-2401 | 2010-12-09 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02905 |
Please comment or provide details below to improve the information on KELLEY LAVINE.
| 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.