MRS. KELLY MAINES SQUIRES (NPI# 1497268320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497268320 |
| Entity Type | Individual |
| Full Name | MRS. KELLY MAINES SQUIRES |
| Credential | CPNP |
| Practice Address |
23 Sunnybrook Rd Raleigh NC 27610-1855 |
| Mailing Address |
8317 City Loft Ct Raleigh NC 27613-6883 |
| Practice Telephone | 9192356435 |
| Mailing Telephone | 3362660872 |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0200X |
Registered Nurse Specialization: Pediatrics |
246271 | NC | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
5010058 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
23 SUNNYBROOK RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27610-1855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386648756 | James A Scovil | Legal Medicine | 23 Sunnybrook Rd, Ste 109, Raleigh, NC 27610-1855 | 2005-06-13 |
| 1861030371 | Macon Louise Cornick Guidry | Dietitian, Registered | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-12-16 |
| 1679129720 | Amelia Willis | Nurse Practitioner | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-08-14 |
| 1497307334 | Wakemed Specialists Group LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-07-11 |
| 1336704766 | Wakemed Specialists Group, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1265097695 | Wakemed Specialists Group, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1245895697 | Wakemed Specialists Group, LLC | Counselor | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1982269346 | Wakemed Specialists Group, LLC | Surgery | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1962067314 | Wakemed Specialists Group, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1659934511 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499243 | Elizabeth Ranganai Mavindidze | Social Worker | Wakemed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610 | 2020-05-18 |
| 1851958839 | Alex & Associates, P.C. | Dentist | 1600 Cross Link Road, Unit 103, Raleigh, NC 27610 | 2019-05-24 |
| 1639646367 | Carol Mary Medins | Dietitian, Registered | Wakemed Raleigh Medical Park, 23 Sunnybrook Road, Suite 200, Raleigh, NC 27610 | 2018-10-31 |
| 1144714601 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 123 Sunnybrook Rd Ste 150, Raleigh, NC 27610 | 2018-06-19 |
| 1417446006 | Eagles Eye Lab, Inc | Clinical Medical Laboratory | 4501 New Bern Ave, Ste: 130, Raleigh, NC 27610 | 2018-05-09 |
| 1316465206 | Jeffery King Neer | Social Worker | 3010 Falstaff Rd., C/o Unc Actt, Raleigh, NC 27610 | 2017-08-31 |
| 1083139885 | Kelsey Daniel Mccleave | Social Worker | 3630 Enduring Freedom Drive, Raleigh, NC 27610 | 2017-08-14 |
| 1891219093 | Tarheel Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4840 Quarryman Road, Raleigh, NC 27610 | 2017-07-29 |
| 1508214826 | Compassionate Care Providers LLC | Respite Care | 5110 Wetlands, Raleigh, NC 27610 | 2016-05-26 |
| 1730552530 | Matthew Belair | Pharmacist | 1601-51 Cross Link Rd, Raleigh, NC 27610 | 2015-11-03 |
| Find all providers in zip 27610 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594732 | Megan Hoekstra | Nurse Practitioner | 8358 Six Forks Rd Ste 204, Raleigh, NC 27615-5093 | 2020-10-04 |
| 1033667621 | Hillary Houghton | Nurse Practitioner | 10211 Alm St # 210, Raleigh, NC 27617 | 2016-09-13 |
| 1568654903 | Malinda Teague | Nurse Practitioner | 2406 Blue Ridge Rd Ste 100, Raleigh, NC 27607 | 2007-08-09 |
| 1124235114 | Amanda Brinson Lorek | Nurse Practitioner | 7990 Corporate Drive, Raleigh, NC 27617-2030 | 2007-05-17 |
| 1457577355 | Debra Lohman Weaver | Nurse Practitioner | 10211 Alm St Ste 212, Raleigh, NC 27617 | 2007-04-18 |
| 1801012604 | Cheryl Lynn Crawford | Nurse Practitioner | 3801 Computer Dr Ste 200, Raleigh, NC 27609-6506 | 2007-04-18 |
| 1992717292 | Kara B. Willette | Nurse Practitioner | 1708 Trawick Rd, Suite 111, Raleigh, NC 27604-3897 | 2006-08-13 |
| 1750359303 | Mary Katherine Carroll | Nurse Practitioner | 7990 Arco Corporate Dr, Raleigh, NC 27617-2029 | 2006-03-09 |
| 1568432961 | Crystal Yazmin Mcneal | Nurse Practitioner | 314 E Hargett St, Raleigh, NC 27601-1436 | 2006-01-26 |
| 1568082642 | Aileen Pierson | Nurse Practitioner | 3350 Six Forks Rd, Raleigh, NC 27609-7233 | 2020-04-20 |
| Find all providers in RALEIGH | ||||
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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.