GRACE KELLEY (NPI# 1487175048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487175048 |
| Entity Type | Individual |
| Full Name | GRACE KELLEY |
| Practice Address |
3174 Packard St Ann Arbor MI 48108 |
| Mailing Address |
2222 Stone Rd Ann Arbor MI 48105-2537 |
| Practice Telephone | 7349711073 |
| Mailing Telephone | 5174422689 |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2018-05-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 718665-1 | NY | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704335813 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 492 1st Ave, New York, NY 100169103 | 5174422689 | 5174422689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538305685 | Grace Kelley | Counselor | 671 Hoes Ln W, Piscataway, NJ 08854-8021 | 2008-12-19 |
| 1285839282 | Grace Kelley | Registered Nurse | 140 Grandview Ave, Waterbury, CT 06708-2505 | 2007-06-19 |
| Street Address |
3174 PACKARD ST |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124085972 | Carisalyn Nicole Cousin | Nurse Practitioner | 3174 Packard St, Ann Arbor, MI 48108-1947 | 2006-04-26 |
| 1467069492 | Corey Telin | Social Worker | 3174 Packard St, Ann Arbor, MI 48108-1947 | 2020-09-24 |
| 1174050694 | Elizabeth Annette Patterson | Nurse Practitioner | 3174 Packard St, Ann Arbor, MI 48108-1947 | 2017-05-15 |
| 1922491760 | Packard Health, Inc. | Clinic/Center | 3174 Packard St, Ann Arbor, MI 48108-1947 | 2015-03-17 |
| 1609216795 | Angie L. Wang | Family Medicine | 3174 Packard St, Ann Arbor, MI 48108-1947 | 2013-07-03 |
| 1700137528 | Kari M Bail | Nurse Practitioner | 3174 Packard St, Ann Arbor, MI 48108-1947 | 2012-09-20 |
| 1982970380 | Ronald Romero | Family Medicine | 3174 Packard St, Ann Arbor, MI 48108-1947 | 2012-03-29 |
| 1225304272 | Victoria Jean Nichols | Family Medicine | 3174 Packard St, Ann Arbor, MI 48108-1947 | 2012-03-23 |
| 1710250477 | Meaghan Cotter | Registered Nurse | 3174 Packard St, Ann Arbor, MI 48108-1947 | 2012-02-10 |
| 1356629844 | Katherine Hoffman | Nurse Practitioner | 3174 Packard St, Ann Arbor, MI 48108-1947 | 2011-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999249 | Creating Brighter Futures | Behavioral Analyst | 4201 Varsity Drive, Ste. C, Ann Arbor, MI 48108 | 2020-07-21 |
| 1326506320 | Michelle Bishop | Behavior Technician | 4935 Birch Hollow Dr, Ann Arbor, MI 48108 | 2019-03-08 |
| 1407326077 | Alexis Ewald | Behavior Technician | 2770 Carpenter Rd., Ann Arbor, MI 48108 | 2018-11-27 |
| 1003308511 | Ann Arbor Dental Specialists | Dentist | 3100 Eisenhower Parkway, Suite 200, Ann Arbor, MI 48108 | 2018-05-31 |
| 1144719295 | Jonathan Parker Etter | Physical Medicine & Rehabilitation | 325 E. Eisenhower, Suite 300, Spc 5744, Ann Arbor, MI 48108 | 2018-05-04 |
| 1427555895 | Blossom Health Services LLC | Social Worker | 2156 Glencoe Hills Dr Apt 12, Ann Arbor, MI 48108 | 2018-04-11 |
| 1669974580 | Camron Anthony Moorehead | Occupational Therapist | 400 E. Eisenhower Parkway Bldg 2, Ste A, Ann Arbor, MI 48108 | 2018-03-07 |
| 1396247862 | Crystal Ann D'agostino | Health Educator | 1169 Oak Valley Drive, Ann Arbor, MI 48108 | 2018-03-01 |
| 1538671250 | Miea Moon | Psychologist | 3200 E Eisenhower Parkway, Moriah Hall, Ann Arbor, MI 48108 | 2017-11-03 |
| 1003355546 | Rachael Connolly | Behavior Technician | 4201 Varsity Drive Suite C, Ann Arbor, MI 48108 | 2017-02-16 |
| Find all providers in zip 48108 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073123857 | Catherine Elizabeth Renner | Nurse Practitioner | 24 Frank Lloyd Wright Dr Lbby L, Ann Arbor, MI 48105-9484 | 2020-08-05 |
| 1043844574 | Courtney Joy Young | Nurse Practitioner | 3071 Signature Blvd Apt E, Ann Arbor, MI 48103-6489 | 2020-02-24 |
| 1093350290 | Justin M Wilbert | Nurse Practitioner | 24 Frank Lloyd Wright Dr # L2300, Ann Arbor, MI 48105-9484 | 2019-11-12 |
| 1821585613 | Jessica Marie Fakhoury | Nurse Practitioner | 1000 E Stadium Blvd Ste 1, Ann Arbor, MI 48104-4616 | 2018-04-17 |
| 1962900241 | Kimberly Jumpp-mehta | Nurse Practitioner | 2100 Springwood Ct, Ann Arbor, MI 48103-2396 | 2018-01-31 |
| 1255765582 | Sarah Pope | Nurse Practitioner | 1014 Island Drive Ct, Apt. 104, Ann Arbor, MI 48105-2027 | 2013-08-22 |
| 1265676233 | Mary Elizabeth Markle | Nurse Practitioner | 412 Longshore Dr, Ann Arbor, MI 48105-1624 | 2009-04-22 |
| 1316004609 | Nancy Agnes Prince | Nurse Practitioner | 1516 Bardstown Trl, Ann Arbor, MI 48105-2876 | 2007-01-03 |
| 1316056005 | Lori Joy Bennett | Nurse Practitioner | 2364 Bishop Ave, Ann Arbor, MI 48105-2248 | 2006-08-29 |
| 1265478176 | Gaia Kile | Nurse Practitioner | 210 Little Lake Dr, Suite 10, Ann Arbor, MI 48103-6218 | 2006-06-20 |
| Find all providers in ANN ARBOR | ||||
Please comment or provide details below to improve the information on GRACE KELLEY.
| 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.