MRS. KELLY JEAN WAY (NPI# 1124274378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124274378 |
| Entity Type | Individual |
| Full Name | MRS. KELLY JEAN WAY |
| Credential | BS, MS, PA-C |
| Practice Address |
326 Washington St Norwich CT 06360-2740 |
| Mailing Address |
34b Springbrook Rd Westerly RI 02891-1001 |
| Practice Telephone | 8608898331 |
| Mailing Telephone | 4013488565 |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2014-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA00473 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
002126 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
326 WASHINGTON ST |
| City | NORWICH |
| State | CT |
| Zip Code | 06360-2740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811992076 | Lisa Ann White | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2005-06-15 |
| 1942818380 | Janankia Andrea Thomas | Counselor | 326 Washington St, Norwich, CT 06360-2740 | 2020-07-22 |
| 1306467170 | Hannah Perna | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2020-05-02 |
| 1851920540 | Nicole Patricia Golden | Registered Nurse | 326 Washington St, Norwich, CT 06360-2740 | 2020-04-04 |
| 1154955854 | Brynne E Radel | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2020-03-03 |
| 1801359955 | James Dreier | Nurse Anesthetist, Certified Registered | 326 Washington St, Norwich, CT 06360-2740 | 2019-04-07 |
| 1346715349 | Aldo Mauricio Velasquez | Physician Assistant | 326 Washington St, Norwich, CT 06360 | 2018-10-05 |
| 1073092557 | Devin Stanton | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2018-08-07 |
| 1699260737 | Kevin Connolly | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2018-06-29 |
| 1275034456 | Lori A Desbonnet | Social Worker | 326 Washington St, Norwich, CT 06360-2740 | 2018-02-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1255961561 | Holly M. Renstrom | Driver | 17 Annadell Rd, Norwich, CT 06360 | 2020-01-26 |
| 1609335397 | Chanel Justice | Social Worker | 2 Clinic Drive, Outpatient Clinic for Children, Norwich, CT 06360 | 2019-03-13 |
| 1457700189 | Michelle Pressler | Pharmacist | 634 West Main St, Norwich, CT 06360 | 2016-06-03 |
| 1265895726 | Katie Johnson | Social Worker | 18 Oneco Street, Norwich, CT 06360 | 2016-04-01 |
| 1871956623 | Lori Deslandes-paz | Pharmacist | 372 West Main Street, Norwich, CT 06360 | 2016-03-30 |
| 1336526193 | Keep An Open Mind, LLC | Marriage & Family Therapist | 12 Cass Street, Suite 202, Norwich, DC 06360 | 2015-04-30 |
| 1588084446 | Kinneri Kothari | Ophthalmology | 79 Wawecus St Ste 105, Norwich, CT 06360 | 2014-04-18 |
| 1962746537 | Robin B Smith | Social Worker | 401 W. Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-20 |
| 1063766400 | Colleen Ellen Phillips-white | Social Worker | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-07 |
| Find all providers in zip 06360 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134114770 | Gerald W Doherty | Physician Assistant | 79 Kerwin Hill Rd, Norwich, VT 05055-9475 | 2005-09-20 |
| 1669031563 | Jaclyn Rose Neveu | Physician Assistant | 164 Otrobando Ave, Norwich, CT 06360-2116 | 2019-06-13 |
| 1215216551 | Tara Michelle Niedzialkowski | Physician Assistant | 55 Calvary Dr, Norwich, NY 13815-1032 | 2011-08-04 |
| 1760790612 | Leslie N Brown | Physician Assistant | 79 Wawecus St, Ste. 101, Norwich, CT 06360-2160 | 2010-09-14 |
| 1003047481 | Melody Mukon | Physician Assistant | 330 Washington St, Suite 220, Norwich, CT 06360-2700 | 2009-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163671 | Kirsten Alexandra Drobiak | Physician Assistant | 37 Jennifer Ln, Griswold, CT 06351-3500 | 2020-10-28 |
| 1255955019 | Amanda Uscilla | Physician Assistant | 20 Hilltop Rd, Bethany, CT 06524-3514 | 2020-06-07 |
| 1689208571 | Sage Ann Miele | Physician Assistant | 149 Water St Apt 32, Norwalk, CT 06854-3758 | 2020-02-28 |
| 1790319655 | Erin Kelly Flynn | Physician Assistant | 464 Congress Ave # Suie260, New Haven, CT 06519-1361 | 2020-02-28 |
| 1659919702 | Jeniece Kayla Wert | Physician Assistant | 100 Church Street South, Suite A230 Room A235, New Haven, CT 06519-1703 | 2019-12-18 |
| 1811547508 | Gabriela M Vargas | Physician Assistant | 24 Hospital Ave # Tower7, Danbury, CT 06810-6099 | 2019-09-16 |
| 1275192049 | Molly J Mable | Physician Assistant | 282 Washington St Fl 1, Hartford, CT 06106-3322 | 2019-06-06 |
| 1003377631 | Stephan Anton Bayer | Physician Assistant | 205 Elm St Apt 5, West Haven, CT 06516-4659 | 2019-03-27 |
| 1578024105 | Vance P Baughman | Physician Assistant | 325 Lafayette St Unit 1003, Bridgeport, CT 06604-5472 | 2019-03-27 |
| 1588121354 | Jason Michael Nies | Physician Assistant | 20 York St # 218, New Haven, CT 06510-3220 | 2019-02-27 |
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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.