MS. PATRICIA A KELLY NMD FNP-BC GNPC-BC NPI 1164435582

NPI Information

NPI: 1164435582
Provider Name: MS. PATRICIA A KELLY, NMD, FNP-BC, GNPC-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
200 OCEANGATE STE 100
LONG BEACH, CA
ZIP 90802
Phone: (888) 562-5442
Get Directions

MS. Patricia A Kelly, NMD, FNP-BC, GNPC-BC is a family nurse practitioner in Long Beach, CA. MS. Patricia A Kelly, NMD, FNP-BC, GNPC-BC NPI is 1164435582. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

200 OCEANGATE STE 100
LONG BEACH, CA
ZIP 90802-317
Phone: (888) 562-5442
Fax: (562) 528-5595

The NPI 1164435582 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/15/2006 and was last updated on 1/10/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		NP04543	OHIO	No
2	363LF0000X	Nurse Practitioner	Family	APRN.CNP.04543	OHIO	Yes
3	363LF0000X	Nurse Practitioner	Family	71000324A	INDIANA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000000577056	OTHER	OHIO	ANTHEM
2	421534506126	OTHER	OHIO	CARESOURCE
3	2271741	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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