NICOLE MICHELLE KELLNER (NPI# 1245581677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245581677 |
| Entity Type | Individual |
| Full Name | NICOLE MICHELLE KELLNER |
| Other Name | NICOLE MICHELLE MOLCHAN |
| Credential | P.A. |
| Practice Address |
9460 Amberdale Dr Ste D North Chesterfield VA 23236-1259 |
| Mailing Address |
Po Box 402924 Atlanta GA 30384-2924 |
| Practice Telephone | 8045330220 |
| Practice Fax Number | 8045330230 |
| Mailing Telephone | 8043202705 |
| Mailing Fax Number | 8043302433 |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2020-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0110004771 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
0110004771 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 40 Medical Park Blvd, Suite A, Petersburg, VA 238059289 | 8045206730 | 8045206731 |
| 9460 Amerdale Drive, Ste D, N. Chesterfield, VA 23236 | 8043202705 | 8043302433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073914602 | Nicole Kellner | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2014-09-15 |
| Street Address |
9460 AMBERDALE DR STE D |
| City | NORTH CHESTERFIELD |
| State | VA |
| Zip Code | 23236-1259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170064 | Yuly Angelica Willard | Assistant Behavior Analyst | 300 Arboretum Pl, Suite 500, Richmond, VA 23236 | 2020-09-28 |
| 1134752892 | Michelle Bland | Mastectomy Fitter | 11533 Busy Street, Mailbox #307, N. Chesterfield, VA 23236 | 2020-02-20 |
| 1629610449 | Daniel John Lammon IIi | Behavioral Analyst | 9201 Arboretum Pkwy #160, Richmond, VA 23236 | 2019-10-14 |
| 1932750320 | Carmelle A Roberts | Technician | 929 Meadowcreek Dr, North Chesterfield, VA 23236 | 2019-09-26 |
| 1386208163 | Mincey Enterprises Inc Dba Senior Helpers | Homemaker | 257 Wadsworth Drive, Richmond, VA 23236 | 2019-04-26 |
| 1306321591 | Katherine Gail Villacorta | Behavior Technician | 9201 Arboretum Pkwy #160, Richmond, VA 23236 | 2018-10-03 |
| 1841713120 | Your Taxi, Inc. | Taxi | 9409 Hull Street Road, Suite F-2, North Chesterfield, VA 23236 | 2017-07-19 |
| 1790125987 | James River Home Health Care, LLC | Home Health | 9100 Arboretum Parkway, Ste 290, North Chesterfield, VA 23236 | 2013-07-02 |
| 1164779591 | Christian Thomsen | Military Health Care Provider | 2510 Camelback Road, Richmond, VA 23236 | 2012-08-03 |
| 1780959171 | Shelby Johnson | Anesthesiology | 215 Wadsworth Drive, Richmond, VA 23236 | 2012-03-19 |
| Find all providers in zip 23236 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790875698 | Jennifer Diane Bauer | Physician Assistant | 10800 Midlothian Tpke Ste 309, North Chesterfield, VA 23235 | 2006-10-13 |
| 1215969100 | Elizabeth F. Hensley | Physician Assistant | 1000 Boulders Pkwy Ste 101, North Chesterfield, VA 23225-5515 | 2006-07-07 |
| 1538104138 | Johnathon Chisum | Physician Assistant | 1115 Boulders Pkwy Ste 100, North Chesterfield, VA 23225-4067 | 2006-06-18 |
| 1780142190 | Christopher Karaffa | Physician Assistant | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235-4765 | 2019-03-05 |
| 1770041188 | Kiersten Nicole Basciano | Physician Assistant | 1051 Johnston Willis Dr Ste 200, North Chesterfield, VA 23235-4871 | 2019-03-05 |
| 1245711340 | Rachel E. J Shields | Physician Assistant | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235 | 2018-08-27 |
| 1710486931 | Emily Nilson | Physician Assistant | 1400 Johnston Willis Dr Ste A, North Chesterfield, VA 23235 | 2018-02-02 |
| 1639616097 | William Bader | Physician Assistant | 1400 Johnston Willis Dr, Suite A, North Chesterfield, VA 23235-4765 | 2017-01-24 |
| 1750826004 | Rachel Lynn Kobeski | Physician Assistant | 2602 Buford Rd, North Chesterfield, VA 23235-3422 | 2016-12-22 |
| 1962865139 | Joshua Storm | Physician Assistant | 201 Wadsworth Dr, North Chesterfield, VA 23236 | 2016-04-04 |
| Find all providers in NORTH CHESTERFIELD | ||||
| City | NORTH CHESTERFIELD |
| Zip Code | 23236 |
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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.