KELLY P MCNULTY (NPI# 1518116359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518116359 |
| Entity Type | Individual |
| Full Name | KELLY P MCNULTY |
| Credential | PA |
| Practice Address |
205 Saint Charles Way York PA 17402-4643 |
| Practice Telephone | 7177414666 |
| Practice Fax Number | 7177410538 |
| Mailing Telephone | (717) 741-4666 |
| Mailing Fax Number | 7177410538 |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA053684 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HIGHMARK BLUE SHIELD - FREEDOM BLUE | 2696616 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 207 Blooming Grove Rd, Hanover, PA 173317917 | 7176325259 | 7176322422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437700697 | Kelly Mcnulty | Nurse's Aide | 6606 Alderson St, Houston, TX 77020-3240 | 2019-09-27 |
| 1770987406 | Kelly Mcnulty | Student in an Organized Health Care Education/Training Program | 240 Long Island Avenue, Wyandanch, NY 11798 | 2014-10-09 |
| Street Address |
205 SAINT CHARLES WAY |
| City | YORK |
| State | PA |
| Zip Code | 17402-4643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215900261 | Ira J Berman | Dermatology | 205 Saint Charles Way, York, PA 17402 | 2006-02-09 |
| 1811249824 | Victoria R Hudak | Registered Nurse | 205 Saint Charles Way, York, PA 17402-4643 | 2012-10-15 |
| 1346471414 | Anessa C Inman | Physician Assistant | 205 Saint Charles Way, York, PA 17402-4659 | 2009-08-06 |
| 1457597635 | Amanda D Haugh | Physician Assistant | 205 Saint Charles Way, York, PA 17402-4659 | 2008-12-18 |
| 1225289408 | John Gillespie Stoner Jr. | Dermatology | 205 Saint Charles Way, York, PA 17404 | 2008-10-06 |
| 1093989832 | Rebecca M Farquhar | Physician Assistant | 205 Saint Charles Way, York, PA 17402-4643 | 2008-04-14 |
| 1386813012 | Luciano John Iorizzo IIi | Dermatology | 205 Saint Charles Way, York, PA 17402-4643 | 2008-02-27 |
| 1053593814 | Heather Leanne Salvaggio | Dermatology | 205 Saint Charles Way, York, PA 17402-4643 | 2007-12-03 |
| 1295936458 | Ninad Pendharkar | Dermatology | 205 Saint Charles Way, York, PA 17402-4659 | 2007-05-29 |
| 1821063801 | Laura S Spears | Dermatology | 205 Saint Charles Way, York, PA 17402 | 2006-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265053987 | Hope Renewed Counseling Services LLC | Social Worker | 879 Clare Lane, York, PA 17402 | 2020-05-04 |
| 1912462292 | Andventure, Inc. | Home Health | Andventure, Inc., 3415c Concord Rd., York, PA 17402 | 2019-01-31 |
| 1407327992 | Tariro Manamike | Pharmacist | Weis Markets Pharmacy, 2400 E Market Street, York, PA 17402 | 2018-12-10 |
| 1689120925 | Benjamin Stahle | Emergency Medicine | 70 Locust Grove Road, York, PA 17402 | 2016-08-28 |
| 1275905614 | Ultra Dental I, LLC | Dentist | 233 Pauline Drive, York, PA 17402 | 2015-10-26 |
| 1215323878 | Sonya Maria Korda | Dentist | 332 Shasta Dr., York, PA 17402 | 2015-04-10 |
| 1588909691 | Kimberly Sue Marsico | Counselor | 3110 East Market St, York, PA 17402 | 2012-11-29 |
| 1184995797 | Ivan Lewis Butler | General Practice | 204 St. Charles Way, Unit 364e, York, PA 17402 | 2012-01-13 |
| 1801117783 | Active Life Chiropractic | Chiropractor | 1915 E. Market Street, York, PA 17402 | 2010-06-15 |
| 1578881652 | Oss Orthopaedic Hospital, LLC | General Acute Care Hospital | 1861 Powder Mill Rd., York, PA 17402 | 2010-05-13 |
| Find all providers in zip 17402 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376153650 | Hannah Christine Kowalewski | Physician Assistant | 1765 Hillock Ln, York, PA 17403-4033 | 2020-08-03 |
| 1306461959 | Brandon Rauhauser | Physician Assistant | 1921 Worth St, York, PA 17404-5230 | 2020-06-09 |
| 1629337902 | Shannon N Moreau | Physician Assistant | 343 Us Route 1, York, ME 03909-1636 | 2012-05-08 |
| 1205117363 | Emily Macik | Physician Assistant | 1001 S George St Fl 3, York, PA 17403-3676 | 2011-09-02 |
| 1366769085 | David Arthur Hamel | Physician Assistant | 85 Brixham Rd, York, ME 03909-5342 | 2010-04-21 |
| 1649448127 | Lauralee Brooke Trump | Physician Assistant | 2532 Knobhill Rd, York, PA 17403-4796 | 2008-02-18 |
| 1699886069 | Cynthia F Helm | Physician Assistant | 1796 3rd Ave, York, PA 17403-1913 | 2006-08-31 |
| 1154393320 | Juliann Pandelidis | Physician Assistant | 80 Wyntre Brooke Dr, York, PA 17403-4535 | 2006-02-02 |
| 1740280031 | Charlotte S. Greene | Physician Assistant | 15 Hospital Dr, York, ME 03909-1011 | 2005-07-28 |
| 1306446166 | Kathryn M Fossaceca | Physician Assistant | 116 S George St, York, PA 17401-1474 | 2020-10-29 |
| Find all providers in YORK | ||||
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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.