KELLY ELIZABETH KOTULA (NPI# 1518519305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1518519305 |
Entity Type | Individual |
Full Name | KELLY ELIZABETH KOTULA |
Credential | DNP, CPNP |
Practice Address |
3665 Kearny Villa Rd Ste 400 San Diego CA 92123-1955 |
Practice Telephone | 8589668801 |
Mailing Telephone | 8589668801 |
Enumeration Date | 2019-07-11 |
Last Update Date | 2020-06-29 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP95012078 | CA | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
NP95012078 | CA | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
7910 Frost St Ste 335, San Diego, CA 921232753 | 8585768010 |
Street Address |
3665 KEARNY VILLA RD STE 400 |
City | SAN DIEGO |
State | CA |
Zip Code | 92123-1955 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992882906 | Mary Alice Melwak | Nurse Practitioner | 3665 Kearny Villa Rd Ste 400, San Diego, CA 92123-1955 | 2006-11-01 |
1558839837 | Nataly E. Rodriguez | Nurse Practitioner | 3665 Kearny Villa Rd Ste 400, San Diego, CA 92123-1955 | 2018-11-05 |
1255817201 | Brittany Vlosich | Audiologist | 3665 Kearny Villa Rd Ste 400, San Diego, CA 92123-1955 | 2018-07-12 |
1700300308 | Michelle Hu | Audiologist-Hearing Aid Fitter | 3665 Kearny Villa Rd Ste 400, San Diego, CA 92123-1955 | 2017-07-26 |
1679096259 | Shani Goldgrub | Audiologist | 3665 Kearny Villa Rd Ste 400, San Diego, CA 92123-1955 | 2017-07-25 |
1528436730 | Brett Jones | Counselor | 3665 Kearny Villa Rd Ste 400, San Diego, CA 92123-1955 | 2015-09-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
Find all providers in zip 92123 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083116321 | Alina Shumakova | Nurse Practitioner | 7910 Frost St Ste 120, San Diego, CA 92123-2776 | 2018-03-02 |
1548545494 | Kyla Jan Gonzalez | Nurse Practitioner | 3020 Childrens Way # Mc5115, San Diego, CA 92123-4223 | 2011-10-11 |
1558699769 | Jeanne Marguerite Niner | Nurse Practitioner | 4873 Sea Lavender Way, San Diego, CA 92154-8559 | 2009-11-28 |
1730336827 | Zohar Mcmurtry | Nurse Practitioner | 200 W Arbor Dr Dept 8452, San Diego, CA 92103-8452 | 2008-08-20 |
1194905489 | Tawnya Lee Macchiarella | Nurse Practitioner | 3860 Calle Fortunada Ste 210, San Diego, CA 92123-4802 | 2007-11-05 |
1053519850 | Rebecca Lee Sox | Nurse Practitioner | 7910 Frost St Ste 360, San Diego, CA 92123 | 2007-07-03 |
1043422884 | Donna J King | Nurse Practitioner | 3071 W. Fox Run Way, San Diego, CA 92111 | 2007-05-04 |
1942331079 | Sandra Marie Hinesly | Nurse Practitioner | 8995 Allenbrook Way, San Diego, CA 92129-2162 | 2007-03-08 |
1992882906 | Mary Alice Melwak | Nurse Practitioner | 3665 Kearny Villa Rd Ste 400, San Diego, CA 92123-1955 | 2006-11-01 |
1790861185 | Franziska Elisabeth Spiegelberg | Nurse Practitioner | 4602 Finsen Ave, San Diego, CA 92122-2708 | 2006-10-27 |
Find all providers in SAN DIEGO |
Please comment or provide details below to improve the information on KELLY ELIZABETH KOTULA.
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.