KELLY KAZLO (NPI# 1588673925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588673925 |
| Entity Type | Individual |
| Full Name | KELLY KAZLO |
| Credential | APRN-BC |
| Practice Address |
Dayton Veterans Affairs 4100 W Third Street Mail Stop 116 Dayton OH 45428 |
| Practice Telephone | 9372686511 |
| Mailing Telephone | 9372686511 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2019-06-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
R126942 | MD | Nursing Service Providers |
| N | 363L00000X | Nurse Practitioner | R126942 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R126942 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
DAYTON VETERANS AFFAIRS 4100 W THIRD STREET MAIL STOP 116 |
| City | DAYTON |
| State | OH |
| Zip Code | 45428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407414527 | Punyawat Laohakanjanasiri | Dentist | Dayton Va Medical Center/dental Services, 4100 W Third, Dayton, OH 45428 | 2019-06-04 |
| 1942716303 | John Korea Lee | Pharmacist | 4100 W. 3rd Street, Attn: Pharmacy Call Center 408pcc, Dayton, OH 45428 | 2017-12-21 |
| 1366876138 | Amber J Enterline | Pharmacist | 4100 W 3rd Street, Attn Pharmacy, Dayotn, OH 45428 | 2013-08-28 |
| 1114155793 | Jeffrey Michael Munn | Dentist | 4100 West 3rd St., Dayton V.a. Medical Center, Dayton, OH 45428 | 2009-06-23 |
| 1558516724 | Tawnyell Nikko Culpepper | Social Worker | 4100 Va Medical Center, Social Work Department Suite 122, Trotwood, OH 45428 | 2008-12-01 |
| 1255586376 | Prasad V Venkat | Physical Therapist | 4100 W.third Street, Dayton, OH 45428 | 2008-11-18 |
| 1457435687 | Reba E Crowell | Nurse Practitioner | 4100 West 3rd Street, Dayton, OH 45428 | 2006-10-24 |
| 1386728632 | Alicia Joann Weekes-johnson | Counselor | 4100 W Third St. Mhlc Bldg 302, Veterans Administration Medical Center, Dayton, OH 45428 | 2006-10-24 |
| 1497843049 | Margaret Irene Kruckemeyer | Nurse Practitioner | 4100 West Third Street (117), Va Medical Center, Dayton, OH 45428 | 2006-10-10 |
| 1003902545 | Mohamed Elmouelhi | Internal Medicine | 4100 W.third St., Dayton Vamc (11c), Dayton, OH 45428 | 2006-10-04 |
| Find all providers in zip 45428 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114540317 | Paul Jutte | Nurse Practitioner | 607 6th Ave, Dayton, KY 41074-1143 | 2020-05-21 |
| 1497363345 | Adrian Hope Bates | Nurse Practitioner | 732 Beckman St, Dayton, OH 45410-2165 | 2020-07-16 |
| 1871134734 | Hannah Elizabeth Cohan | Nurse Practitioner | 1222 S Patterson Blvd Ste 230, Dayton, OH 45402 | 2019-10-02 |
| 1952968638 | Olivia Susan Wilkinson | Nurse Practitioner | 7200 Rhea County Hwy, Dayton, TN 37321-6288 | 2019-05-28 |
| 1316412174 | Justine Holthaus | Nurse Practitioner | 4100 W 3rd St, Dayton, OH 45428-9000 | 2018-10-09 |
| 1922512821 | Amber Mckinney | Nurse Practitioner | 1 Elizabeth Pl Ste D, Dayton, OH 45417-3445 | 2017-11-30 |
| 1134647522 | Beverly J Cobb | Nurse Practitioner | 5350 Lamme Rd, Dayton, OH 45439 | 2017-09-06 |
| 1235683970 | Andrea Mercuri | Nurse Practitioner | 4100 W 3rd St, Mental Health Clinic, Dayton, OH 45428-9000 | 2016-08-11 |
| 1295186898 | Stephanie Louise Weigel | Nurse Practitioner | 600 Wayne Avenue, Dayton, OH 45410 | 2016-06-24 |
| 1376926253 | Melinda Kiser | Nurse Practitioner | 600 Wayne Ave, Dayton, OH 45410-1122 | 2015-07-09 |
| Find all providers in DAYTON | ||||
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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.