KELLY EVERDEN


Address: 1051 Arlene Ave, Pontiac, MI 48340-2904
Phone: 2484517365

KELLY EVERDEN (NPI# 1629141999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629141999
Entity Type Individual
Full Name KELLY EVERDEN
Credential CPNP
Practice Address 1051 Arlene Ave
Pontiac
MI 48340-2904
Mailing Address 46 N Saginaw St
Oakland Primary Health Services
Pontiac
MI 48342-2155
Practice Telephone 2484517365
Practice Fax Number 2484517370
Mailing Telephone 2483226747
Mailing Fax Number 2483225787
Enumeration Date 2006-11-16
Last Update Date 2011-08-30
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
4704213499 MI Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1051 ARLENE AVE
City PONTIAC
State MI
Zip Code 48340-2904

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700315223 Oakland Integrated Healthcare Network Clinic/Center 1051 Arlene Ave, Pontiac, MI 48340-2904 2017-06-08
1538586854 Aleta Blanche Curry Counselor 1051 Arlene Ave, Pontiac, MI 48340-2904 2014-03-25
1245588912 Frederika Robinson Nurse Practitioner 1051 Arlene Ave, Pontiac, MI 48340-2904 2012-08-28

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851882799 Maryan Luay Alkhoory Dentist 1620 N Perry St # 1, Pontiac, MI 48340 2018-05-26
1669907689 Jeffrey D Bryant Social Worker 1841 N. Perry St, Pontiac, MI 48340 2017-04-27
1750822748 Star Dental P.C. Dentist 775 Baldwin Rd, Suite C, Pontiac, MI 48340 2017-03-10
1609237965 Stephanie Stephan Dentist 1590 Baldwin Ave, Auburn Hills, MI 48340 2016-03-15
1376908921 Jump Start LLC Maternal Infant Health Program Exclusive Provider Organization 1086 Williamson Cir, Pontiac, MI 48340 2015-12-28
1417339532 Ana Rodriguez Point of Service 612 Peacock Ave, Pontiac, MI 48340 2015-06-25
1104223544 Tammy Fletcher Registered Nurse 1841 N Perry, Pontiac, MI 48340 2014-12-01
1558629238 Oakland Integrated Healthcare Network Clinic/Center 816 Joslyn, Pontiac, MI 48340 2012-05-01
1447583398 Dial A Doc Physicians PC Pain Medicine 28 N Saginaw, Chase Building, Pontiac, MI 48340 2009-09-10
1619199171 Jann E. Trzeciak Family Medicine 1915 N Perrt Street, Pontiac, MI 48340 2007-05-03
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Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

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1093351595 Emily Janina Jamett Nurse Practitioner 31815 Southfield Rd Ste 10, Beverly Hills, MI 48025-5471 2019-11-20
1508410747 Clorissa Diedrich Nurse Practitioner 829 N Center Ave Ste 130, Gaylord, MI 49735-1684 2019-07-25
1255895355 Jessica Lynn Kata Nurse Practitioner 19229 Mack Ave Ste 28, Grosse Pointe Woods, MI 48236-2857 2019-01-23
1467934679 Anita Lynn Riddle Nurse Practitioner 100 W. Vanburen Street, Battle Creek, MI 49017 2018-09-04
1285120634 Alexandra Danko Nurse Practitioner 5500 Auto Club Dr Ste 160, Dearborn, MI 48126-2779 2018-07-09
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Competitor

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City PONTIAC
Zip Code 48340

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Dataset Information

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.

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