KELLY COLLURA (NPI# 1548738248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548738248 |
| Entity Type | Individual |
| Full Name | KELLY COLLURA |
| Practice Address |
205 E Nasa Blvd Fl 2 Melbourne FL 32901-1950 |
| Mailing Address |
3300 S Fiske Blvd Rockledge FL 32955-4306 |
| Practice Telephone | 3213615629 |
| Practice Fax Number | 3216766434 |
| Mailing Telephone | 3213615629 |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2020-08-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | APRN9404112 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 106050000 | 05 | |
| FL | MEDICARE | MF482 | 01 |
| Street Address |
205 E NASA BLVD FL 2 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-1950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790750388 | Lizamar S Korfhage | Physician Assistant | 205 E Nasa Blvd Fl 2, Melbourne, FL 32901-1950 | 2006-02-17 |
| 1477009553 | Sabrina Blancas | Nurse Practitioner | 205 E Nasa Blvd Fl 2, Melbourne, FL 32901 | 2016-08-29 |
| 1841643079 | Barbara Anne Baute | Nurse Practitioner | 205 E Nasa Blvd Fl 2, Melbourne, FL 32901-1950 | 2016-07-23 |
| 1619266806 | Markand J Patel | Anesthesiology | 205 E Nasa Blvd Fl 2, Melbourne, FL 32901 | 2011-03-29 |
| 1679690093 | Ashraf A. M. Ahmed | Internal Medicine | 205 E Nasa Blvd Fl 2, Melbourne, FL 32901-1950 | 2007-03-22 |
| 1811962855 | Vincenzo Scotto D'antuono | Internal Medicine | 205 E Nasa Blvd Fl 2, Melbourne, FL 32901-1950 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871105411 | Nina Teresa Solar | Nurse Practitioner | 129 W Hibiscus Blvd Ste A, Melbourne, FL 32901-3006 | 2020-08-17 |
| 1629686415 | Johanna B Pillado | Nurse Practitioner | 1800 Brookshire Cir, Melbourne, FL 32904-6670 | 2020-07-17 |
| 1659900181 | Lindsay Hayes | Nurse Practitioner | 1681 Wekiva Dr, Melbourne, FL 32940-6986 | 2020-04-06 |
| 1548808439 | Robert Mathew Johnson | Nurse Practitioner | 4898 Erin Ln, Melbourne, FL 32940-7156 | 2019-12-11 |
| 1619533940 | Jessica Nicole Bartlett | Nurse Practitioner | 3021 W Eau Gallie Blvd Ste 102, Melbourne, FL 32934-7005 | 2019-05-13 |
| 1811476450 | Ashley Ricks Hampton | Nurse Practitioner | 1070 Cayman Dr, Melbourne, FL 32901-8645 | 2018-08-13 |
| 1245752070 | Morgan Brittany Shirley | Nurse Practitioner | 1019 E. Main St., Melbourne, AR 72556 | 2017-07-13 |
| 1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
| 1699058263 | Deborah Susan Coon | Nurse Practitioner | 1223 Gateway Dr Ste 1f, Melbourne, FL 32901-2607 | 2011-09-21 |
| 1043509300 | Elizabeth Marie Ambrose | Nurse Practitioner | 1223 Gateway Drivie, Suite 1c, Melbourne, FL 32901-2607 | 2011-04-06 |
| Find all providers in MELBOURNE | ||||
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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.