MRS. KELLY SMIDEBUSH (NPI# 1104176833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104176833 |
| Entity Type | Individual |
| Full Name | MRS. KELLY SMIDEBUSH |
| Credential | ARNP |
| Practice Address |
129 E Redstone Ave Suite A Crestview FL 32539-5350 |
| Practice Telephone | 8506827212 |
| Practice Fax Number | 8506826302 |
| Mailing Telephone | 8506827212 |
| Mailing Fax Number | 8506826302 |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2012-10-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | ARNP9279024 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
129 E REDSTONE AVE SUITE A |
| City | CRESTVIEW |
| State | FL |
| Zip Code | 32539-5350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336134220 | Juan Carlos Zarate | Internal Medicine | 129 E Redstone Ave, Suite A, Crestview, FL 32539-5364 | 2005-09-16 |
| 1578664140 | Michael L Yandel | Internal Medicine | 129 E Redstone Ave, Suite A, Crestview, FL 32539-5364 | 2006-09-26 |
| 1144270240 | Okaloosa Cardiology P A | Surgery | 129 E Redstone Ave, Suite A, Crestview, FL 32539-5350 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326418336 | Abc Pediatrics of Okaloosa | Pediatrics | 182 E. Redstone Ave, Suite B, Crestview, FL 32539 | 2015-10-02 |
| 1336498443 | Jessica Carolina Carroll | Counselor | 259 E. Oakdale Ave, Crestview, FL 32539 | 2012-09-05 |
| 1902167166 | Patricia Guess | Registered Nurse | 6011 Aubrey Lee Ln, Crestview, FL 32539 | 2012-06-05 |
| 1699048181 | Chien Nguyen | Clinical Medical Laboratory | 151 East Redstone Avenue, Crestview, FL 32539 | 2012-02-15 |
| 1043494164 | Crestview Mri | Clinic/Center | 700 Hospital Drive, Crestview, FL 32539 | 2007-12-26 |
| 1558581215 | Barnes Healthcare of Fl LLC | Durable Medical Equipment & Medical Supplies | 450 Brookmeade Dr, Crestview, FL 32539 | 2007-04-26 |
| 1568576098 | Okaloosa Youth Development Center | Substance Abuse Rehabilitation Facility | 4449 Straighline Road, Crestview, FL 32539 | 2006-08-19 |
| 1154368181 | Marcello Borzatta | Surgery | 129 E. Redstone Ave, Suite A, Crestview, FL 32539 | 2006-05-31 |
| 1902850258 | Panhandle Orthopaedics LLC | Physical Therapist | 710 Hospital Drive, Crestview, FL 32539 | 2006-05-20 |
| 1619941440 | Yale R Smith | Anesthesiology | 151 Redstone Ave Se, Pinnacle Physicians LLC, Crestview, FL 32539 | 2006-02-16 |
| Find all providers in zip 32539 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083967756 | William Douglas Necaise | Nurse Practitioner | 2640 Sorrel Ridge Rd, Crestview, FL 32536-4329 | 2012-10-18 |
| 1508141375 | Sharon Skrabacz | Nurse Practitioner | 127 E Redstone Ave Ste B, Crestview, FL 32539-5356 | 2011-10-12 |
| 1881835122 | Beckie L Turner | Nurse Practitioner | 1209 Pinewood Ln, Crestview, FL 32539-8509 | 2009-03-17 |
| 1366690455 | Lela Mae Stroud | Nurse Practitioner | 2875 Lake Silver Rd, Crestview, FL 32536-7183 | 2008-09-03 |
| 1740227503 | Christina Cerise Johnson | Nurse Practitioner | 302 E James Lee Blvd, Crestview, FL 32539-2827 | 2006-06-01 |
| 1003372194 | Adam C Hargis | Nurse Practitioner | 151 E Redstone Ave, Crestview, FL 32539-5352 | 2019-02-14 |
| 1194244558 | Brandie Crawford | Nurse Practitioner | 600 Hospital Dr, Crestview, FL 32539-7356 | 2017-09-15 |
| 1740639731 | Jung Hyun Koh | Nurse Practitioner | 550 Redstone Ave W, Suite 200, Crestview, FL 32536-6428 | 2016-06-09 |
| 1962453969 | Angelo Marcus Mishio | Nurse Practitioner | 151 E Redstone Ave, Crestview, FL 32539-5352 | 2006-05-14 |
| 1336126978 | Okaloosa Emergency Group LLC | Nurse Practitioner | 151 E Redstone Ave, Crestview, FL 32539-5352 | 2005-12-26 |
| Find all providers in CRESTVIEW | ||||
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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.