KELLY JEAN WENKO (NPI# 1871883959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871883959 |
| Entity Type | Individual |
| Full Name | KELLY JEAN WENKO |
| Credential | CRNP |
| Practice Address |
765 Liberty St Suite 202 Meadville PA 16335-2566 |
| Practice Telephone | 8143335888 |
| Practice Fax Number | 8143335026 |
| Mailing Telephone | 8143335888 |
| Mailing Fax Number | 8143335026 |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2011-04-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
SP011351 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | PENNSYLVANIA DEPARTMENT OF STATE | SP011351 | 01 |
| Street Address |
765 LIBERTY ST SUITE 202 |
| City | MEADVILLE |
| State | PA |
| Zip Code | 16335-2566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578566113 | Sharon Palotas | Nurse Practitioner | 765 Liberty St, Suite 309, Meadville, PA 16335-2566 | 2005-05-27 |
| 1124408604 | Meadville Physician Services | Internal Medicine | 765 Liberty St, Ste 309, Meadville, PA 16335-2566 | 2015-06-01 |
| 1225432545 | Emily Prenatt | Physician Assistant | 765 Liberty St, Meadville, PA 16335-2566 | 2014-10-15 |
| 1962804955 | French Creek Internal Medicine | Internal Medicine | 765 Liberty St, 307, Meadville, PA 16335-2566 | 2014-09-22 |
| 1801296470 | Oyler Internal Medicine, LLC | Internal Medicine | 765 Liberty St, Suite 307, Meadville, PA 16335-2566 | 2014-09-02 |
| 1255773784 | Dipesh Maan | Internal Medicine | 765 Liberty St, Meadville, PA 16335-2566 | 2013-07-25 |
| 1093154924 | Meadville Physician Services | Family Medicine | 765 Liberty St, Suite 310, Meadville, PA 16335-2566 | 2013-06-25 |
| 1831534189 | Anthony Randolph | Internal Medicine | 765 Liberty St, Suite 307, Meadville, PA 16335-2566 | 2013-04-30 |
| 1538420658 | Meadville Medical Center | Psychiatry & Neurology | 765 Liberty St, Suite 303, Meadville, PA 16335-2566 | 2012-06-05 |
| 1114287414 | Meadville Physician Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 765 Liberty St, Suite 105, Meadville, PA 16335-2566 | 2012-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811533508 | Stacey Lynette Lantz | Physical Therapy Assistant | 11277 Vernon Place Road, Meadville, PA 16335 | 2019-11-18 |
| 1952874794 | Amy Lynn Weaver | Social Worker | Parkside Psychological Associates, 435 Chestnut Street, Meadville, PA 16335 | 2019-01-04 |
| 1013437789 | Raymond Walter Keller Jr. | Family Medicine | 735 Liberty St, Meadville, PA 16335 | 2017-06-23 |
| 1750735742 | Nicole Fies | Counselor | 201 Chestnut Street, Floor 2, Meadville, PA 16335 | 2016-04-16 |
| 1760894422 | Amie S Coffman | Psychiatry & Neurology | 765 Liberty St Ste 303, Meadville, PA 16335 | 2014-05-28 |
| 1649609710 | Gina Marie Michalak | Pharmacist | 379 North Street, Meadville, PA 16335 | 2013-11-08 |
| 1518396704 | Cassandra Lynn Ketler | Physician Assistant | 847 North Main Street, Meadville, PA 16335 | 2013-11-07 |
| 1194159913 | Judy Mcelwain | Speech-Language Pathologist | 31 N Park Ave, Meadville, PA 16335 | 2013-08-28 |
| 1649604463 | Jonelle Elizabeth Taylor | Occupational Therapist | 31 North Park Ave, Meadville, PA 16335 | 2013-08-28 |
| 1699046961 | James Richard Mclamb | Orthopaedic Surgery | 6060 Ehrgott Rd, Meadville, PA 16335 | 2012-01-19 |
| Find all providers in zip 16335 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770803 | Mwasnoh L Jebboe | Nurse Practitioner | 7740 Lucretia Mott Way Apt A, Elkins Park, PA 19027-1041 | 2020-11-04 |
| 1588284517 | Crystal Lee Lash | Nurse Practitioner | 9002 Knoll St, Allison Park, PA 15101-2725 | 2020-04-20 |
| 1770110264 | Kirsten Marie Bickert | Nurse Practitioner | 828 Creek Rd, Walnutport, PA 18088-9712 | 2020-03-24 |
| 1316588585 | Jaimie Sholinsky | Nurse Practitioner | 5401 Old York Rd Bldg Floor3, Philadelphia, PA 19141-3030 | 2019-09-30 |
| 1629531645 | Kathryn Jo Duray | Nurse Practitioner | 1450 Scalp Ave Ste 3b, Johnstown, PA 15904-3321 | 2019-04-08 |
| 1366900490 | Leigh Ferguson | Nurse Practitioner | 210 S 25th St Unit 1402, Philadelphia, PA 19103-5886 | 2019-03-07 |
| 1497220131 | Margaret Kathleen Halloran | Nurse Practitioner | 1501 Lansdowne Ave Mob, 1st Floor, Darby, PA 19023 | 2018-10-09 |
| 1073003760 | Enjoli Rogers | Nurse Practitioner | 495 Thomas Jones Way Ste 210, Exton, PA 19341-2553 | 2018-05-17 |
| 1992215693 | Luz Anuri Drummond | Nurse Practitioner | 834 Eaton Ave, Bethlehem, PA 18018-1832 | 2017-10-07 |
| 1306356498 | Donna Michelle Depalmo-wilson | Nurse Practitioner | 700 Spruce St Fl 2, Philadelphia, PA 19106-4022 | 2017-10-03 |
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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.