JACQUELINE KELLY KEITH (NPI# 1326543877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326543877 |
| Entity Type | Individual |
| Full Name | JACQUELINE KELLY KEITH |
| Credential | MSN, RN |
| Practice Address |
130 Carbonton Rd Sanford NC 27330-4009 |
| Mailing Address |
174 Saddlebrook Dr Sanford NC 27330-9174 |
| Practice Telephone | 9197746521 |
| Practice Fax Number | 9197766179 |
| Mailing Telephone | 9197210118 |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2018-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
141062 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
130 CARBONTON RD |
| City | SANFORD |
| State | NC |
| Zip Code | 27330-4009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720017122 | John G. Wagnitz | Psychiatry & Neurology | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2006-06-30 |
| 1194335224 | Teresa Lorraine Fuller | Clinical Nurse Specialist | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2020-08-04 |
| 1821608258 | Katharine Marie Hargreaves | Counselor | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2020-07-31 |
| 1295374569 | Crystal Alene Waddell | Social Worker | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2020-01-03 |
| 1861035594 | Theresa Gloria King | Social Worker | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2019-10-25 |
| 1194367193 | Tonya Lee Combs | Counselor | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2019-10-10 |
| 1144873738 | Krysta Leeamber Sink | Social Worker | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2019-07-22 |
| 1568026813 | Gwen Clayton Byrd | Licensed Practical Nurse | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2019-04-23 |
| 1346700416 | Blair Ashley Somerville | Counselor | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2019-03-23 |
| 1205393063 | Samuel Lee Parker | Counselor | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2019-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043836232 | Felicia Alston | Chore Provider | 160a Chatham St, Sanford, NC 27330 | 2020-06-23 |
| 1730727470 | Kathy M Taylor | Homemaker | 1665 Lower Moncure Rd, Sanford, NC 27330 | 2019-12-12 |
| 1982185377 | Fhpg, LLC | Internal Medicine | 2925 Beechtree Dr, Suite 142, Sanford, NC 27330 | 2018-08-24 |
| 1154849719 | Schuyler Karl Behnke | Family Medicine | 125 Chatham Street, Sanford, NC 27330 | 2017-09-05 |
| 1205375953 | Dlp Central Carolina Medical Group LLC | Surgery | 117 Dennis Dr, Sanford, NC 27330 | 2017-02-14 |
| 1760921613 | Open Water Medical, Pa | Family Medicine | 109 South Vance St, Sanford, NC 27330 | 2017-02-13 |
| 1972050458 | Brent Layne | Physician Assistant | 724 South Horner Blvd, Sanford, NC 27330 | 2016-09-01 |
| 1174977185 | Jennifer Lynn Beard | Physician Assistant | 2412 Wilkins Drive, Sanford, NC 27330 | 2016-04-15 |
| 1003277252 | North Carolina Wellness | Community/Behavioral Health | 321a Court Square, Sanford, NC 27330 | 2016-03-16 |
| 1518343573 | The Family Doc Back To Basics Medical Practice, Pllc | General Practice | 1503 Elm Street, Suite C, Sanford, NC 27330 | 2015-07-31 |
| Find all providers in zip 27330 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335224 | Teresa Lorraine Fuller | Clinical Nurse Specialist | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2020-08-04 |
| 1710453261 | Geneva Nicole Collins | Clinical Nurse Specialist | 130 Carbonton Rd, Sanford, NC 27330-4009 | 2018-10-22 |
| 1700052214 | Jessica K Shutt | Clinical Nurse Specialist | 1403 Medical Plaza Dr, 202, Sanford, FL 32771-1000 | 2008-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023393410 | Cathy Showfety Inc. | Clinical Nurse Specialist | 408 1/2 State St, Greensboro, NC 27405-5657 | 2011-10-17 |
| 1699078246 | Mary Lynn Piven | Clinical Nurse Specialist | 365 Highway 87 N, Pittsboro, NC 27312 | 2010-12-20 |
| 1316130990 | Kelly L Smedley | Clinical Nurse Specialist | 5318 Highgate Dr Ste 231, Durham, NC 27713-6631 | 2007-08-27 |
| 1922210558 | William Garrett Stone | Clinical Nurse Specialist | 309 W Weaver St, Suite 200, Carrboro, NC 27510-6005 | 2007-05-04 |
| 1609992007 | Carol Faye Peindl | Clinical Nurse Specialist | 12617 Kencot Ct, Huntersville, NC 28078-5715 | 2007-03-21 |
| 1679667133 | Deborah Herring Perry | Clinical Nurse Specialist | 208 Malloy Street, Unit E, Goldsboro, NC 27534 | 2006-10-02 |
| 1154374478 | Bonnie Kennedy | Clinical Nurse Specialist | 3518 Drawbridge Pkwy, Greensboro, NC 27410-8432 | 2006-05-18 |
| 1730152620 | Marianne Mciver | Clinical Nurse Specialist | 234 E Raleigh St, Siler City, NC 27344-3416 | 2006-02-10 |
| 1699398529 | Gina Bourne | Clinical Nurse Specialist | 227 N Main St Ste A, Troy, NC 27371-3059 | 2020-05-27 |
| 1700408200 | Lisa Granieri | Clinical Nurse Specialist | 277 Biltmore Ave, Asheville, NC 28801-4157 | 2020-05-07 |
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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.