KELLY PEZZELLA (NPI# 1679879241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679879241 |
| Entity Type | Individual |
| Full Name | KELLY PEZZELLA |
| Credential | NP |
| Practice Address |
1600 Grand Ave Macalester College Health and Wellness Center Saint Paul MN 55105-1801 |
| Mailing Address |
4152 Columbus Avenue Minneapolis MN 55407 |
| Practice Telephone | 6516966275 |
| Mailing Telephone | 6516410435 |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2011-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | R-174313-3 | MN | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R-174313-3 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1600 GRAND AVE MACALESTER COLLEGE HEALTH AND WELLNESS CENTER |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55105-1801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801085436 | Kathryn Ann Mcnaul | Nurse Practitioner | 1600 Grand Ave, Winton Health Services, Saint Paul, MN 55105-1801 | 2007-10-19 |
| 1487045886 | Paula Natvig | Specialist/Technologist | 1600 Grand Ave, Saint Paul, MN 55105-1801 | 2015-02-07 |
| 1487933123 | Elisabeth J Garms | Specialist/Technologist | 1600 Grand Ave, Saint Paul, MN 55105-1899 | 2011-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437704020 | Grand Avenue Smiles | Dentist | 1845 Grand Avenue, St. Paul, MN 55105 | 2019-08-09 |
| 1205304839 | Michelle Marie Loken Price | Acupuncturist | 877 Lincoln Ave, Saint Paul, MN 55105 | 2018-11-13 |
| 1326566936 | Becky Lynn Lawyer | Counselor | 1704 Palace Ave, St Paul, MN 55105 | 2017-09-04 |
| 1679020226 | Internal Revolution Counseling and Consulting, L.L.C. | Psychologist | 1123 Grand Avenue, Suite 201, Saint Paul, MN 55105 | 2016-09-01 |
| 1487059689 | Jennifer Mason | Lactation Consultant, Non-RN | 1382 Summit Ave, Saint Paul, MN 55105 | 2014-10-30 |
| 1679818850 | Marc Lane Wolfson | Registered Nurse | 1148 Grand Avenue, St. Paul, MN 55105 | 2012-11-29 |
| 1457602781 | Charting Your Success | Social Worker | 2050 St Clair Avenue, Suite 1e, St Paul, MN 55105 | 2012-09-26 |
| 1871867549 | Stacia Hanson Ma Lp LLC | Psychologist | 889 Grand Avenue, Suite 203, St Paul, MN 55105 | 2012-02-28 |
| 1265718142 | Caitlin Marie Young | Midwife | 968 Grand Ave., St. Paul, MN 55105 | 2011-10-24 |
| 1659512622 | Wellness Cooperative LLC | Chiropractor | 976 Grand Ave., St. Paul, MN 55105 | 2009-03-20 |
| Find all providers in zip 55105 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013535426 | Chesley Stanley | Nurse Practitioner | 3113 Fletcher Dr, Saint Paul, VA 24283-3763 | 2020-07-13 |
| 1568002160 | Amazing Grace Health | Nurse Practitioner | 625 Snelling Ave N Ste A, Saint Paul, MN 55104-5585 | 2020-01-10 |
| 1265907083 | Lillia Budd | Nurse Practitioner | 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 | 2018-10-08 |
| 1710403118 | Liv-on Family Care Center, Pa | Nurse Practitioner | 1210 County Road J Ste 102, Saint Paul, MN 55127-6826 | 2017-08-17 |
| 1225588668 | Katie-anne Swenson | Nurse Practitioner | 2550 University Ave W Ste 325s, Saint Paul, MN 55114-1903 | 2016-10-10 |
| 1619329133 | Lamin Jaiteh | Nurse Practitioner | 2550 University Ave W Ste 325-s, Saint Paul, MN 55114-1052 | 2016-07-08 |
| 1457746281 | Florence Fon | Nurse Practitioner | 5 County Road B E Ste 3, Saint Paul, MN 55117-1945 | 2015-03-30 |
| 1639576994 | Angela Denise Lentz | Nurse Practitioner | 178 9th St E Ste 300, Saint Paul, MN 55101-2577 | 2014-12-01 |
| 1548506405 | Mandi Sue Counters | Nurse Practitioner | 14635 Pennock Ave Ste 200, Saint Paul, MN 55124-6587 | 2012-12-21 |
| 1528315470 | Amanda Jeanne Carroll | Nurse Practitioner | 1358 Kent St, Saint Paul, MN 55117-4226 | 2012-08-09 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55105 |
Please comment or provide details below to improve the information on KELLY PEZZELLA.
| 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.