KELLY NORDSTROM (NPI# 1306371083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306371083 |
| Entity Type | Individual |
| Full Name | KELLY NORDSTROM |
| Credential | LVN |
| Practice Address |
4974 El Cajon Blvd Suite A San Diego CA 92115-4654 |
| Mailing Address |
4974 El Cajon Blvd. Suite A San Diego CA 92115 |
| Practice Telephone | 6192864600 |
| Mailing Telephone | 6192864600 |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164X00000X | Licensed Vocational Nurse | VN 215014 | CA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194930370 | Kelly Lynn Shanley Nordstrom | Pharmacist | 2321 Stout Rd, Menomonie, WI 54751-7003 | 2007-05-11 |
| 1548363005 | Kelly Sue Nordstrom | Pharmacist | 325 E H St, Iron Mountain, MI 49801-4760 | 2006-09-07 |
| 1689642076 | Kelly M Nordstrom | Nurse Practitioner | 9 Hope Ave, Waltham, MA 02453-2741 | 2006-03-10 |
| Street Address |
4974 EL CAJON BLVD SUITE A |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92115-4654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932251550 | Progressive Medical Specialists LLC | Clinic/Center | 4974 El Cajon Blvd, Suite A, San Diego, CA 92115-4677 | 2007-01-16 |
| 1548806623 | April J Greenwood | Licensed Vocational Nurse | 4974 El Cajon Blvd, San Diego, CA 92115-4654 | 2019-11-22 |
| 1982173266 | Theresa Maria Drobina | Licensed Vocational Nurse | 4974 El Cajon Blvd, San Diego, CA 92115-4654 | 2018-11-16 |
| 1992237150 | Saleem Malik | Counselor | 4974 El Cajon Blvd, Suite A, San Diego, CA 92115-4654 | 2017-03-28 |
| 1861942104 | Kirk Lamar | Counselor | 4974 El Cajon Blvd, Suite A, San Diego, CA 92115-4654 | 2016-10-11 |
| 1285087718 | Lois Fossing | Licensed Practical Nurse | 4974 El Cajon Blvd, Suite A, San Diego, CA 92115-4677 | 2016-07-20 |
| 1063885010 | Susan Babcock | Counselor | 4974 El Cajon Blvd, San Diego, CA 92115-4654 | 2015-11-12 |
| 1477925337 | Patty Reyes | Licensed Practical Nurse | 4974 El Cajon Blvd, Suite A, San Diego, CA 92115-4654 | 2015-10-30 |
| 1295104586 | Danalee Delossantos | Licensed Vocational Nurse | 4974 El Cajon Blvd, Suite A, San Diego, CA 92115-4677 | 2015-09-17 |
| 1205205572 | Joan Fernandez | Licensed Vocational Nurse | 4974 El Cajon Blvd, Suite A, San Diego, CA 92115-4677 | 2015-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790313922 | Mayra Ailed Bugarin | Student in an Organized Health Care Education/Training Program | City Heights Family Health Center 5454, El Cajon Blvd, San Diego, CA 92115 | 2020-04-01 |
| 1093369878 | Chang Liu | Counselor | 3539 College Avenue, San Diego, CA 92115 | 2019-07-30 |
| 1689238560 | Donia Ahadian | Student in an Organized Health Care Education/Training Program | City Heights Family Health Center, 5454 El Cajon Blvd, San Diego, CA 92115 | 2019-04-26 |
| 1780157859 | James Michael Sites | Military Health Care Provider | Uss Shoup Ddg 86, San Diego, CA 92115 | 2019-01-10 |
| 1780163006 | Marcos Luis Sandoval | Case Manager/Care Coordinator | 6224 El Cajon Blvd, Suite 17, San Diego, CA 92115 | 2018-08-08 |
| 1437651981 | Phyllis Lynette Pryor | Licensed Vocational Nurse | 4974 El Cajon Blvd Suite A, San Diego, CA 92115 | 2018-03-01 |
| 1982125605 | Ellen Medical Transport | Non-emergency Medical Transport (VAN) | 4587 Winona Ave #5, San Diego, CA 92115 | 2017-07-03 |
| 1992225296 | P'okot LLC | Non-emergency Medical Transport (VAN) | 5511 Adelaide Ave, 26, San Diego, CA 92115 | 2017-06-27 |
| 1578019840 | Alfred Zygmunt Nowak | Specialist/Technologist | 6663 Reservoir Ln, San Diego, CA 92115 | 2016-08-28 |
| 1639534183 | Kalkaal Financial Enterprise, LLC. | Non-emergency Medical Transport (VAN) | 5055 Collwood Blvd., Unit 108, San Diego, CA 92115 | 2015-12-29 |
| Find all providers in zip 92115 | ||||
| Taxonomy Code | 164X00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Vocational Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952908782 | Ying Pan | Licensed Vocational Nurse | 9909 Azuaga St Unit C107, San Diego, CA 92129-6019 | 2020-10-05 |
| 1194336982 | Adelita Jasso | Licensed Vocational Nurse | 446 Alta Rd # 300, San Diego, CA 92158-0001 | 2020-08-14 |
| 1750909156 | Hillary Carlson | Licensed Vocational Nurse | 4651 36th St, San Diego, CA 92116-3642 | 2020-07-12 |
| 1841816501 | Cristiana Paris Zajac | Licensed Vocational Nurse | 2654 Worden St Unit 106, San Diego, CA 92110-5849 | 2020-06-18 |
| 1952922783 | Rosalie Ramos Gayares | Licensed Vocational Nurse | Del Sur Crisis Center, San Diego, CA 92154 | 2020-05-04 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1720555659 | Noelle Dizon | Licensed Vocational Nurse | 3585 Acacia St, San Diego, CA 92113-3130 | 2018-10-29 |
| 1285114728 | Tashiya Jean Miller | Licensed Vocational Nurse | 3053 Chamoune Ave, San Diego, CA 92105-4307 | 2018-08-15 |
| 1013402445 | Eduardo Carrera | Licensed Vocational Nurse | 11210 Corte Playa Corona, San Diego, CA 92124-4134 | 2018-06-27 |
| 1437651981 | Phyllis Lynette Pryor | Licensed Vocational Nurse | 4974 El Cajon Blvd Suite A, San Diego, CA 92115 | 2018-03-01 |
| Find all providers in SAN DIEGO | ||||
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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.