CATHERINE GRACE KELLY (NPI# 1609280833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609280833 |
| Entity Type | Individual |
| Full Name | CATHERINE GRACE KELLY |
| Credential | FNP |
| Practice Address |
Corner of Route N12 and N7 Fort Defiance AZ 86504 |
| Mailing Address |
Po Box 3981 Fort Defiance AZ 86504-3981 |
| Practice Telephone | 9287298600 |
| Mailing Telephone | 4065390521 |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2019-11-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NUR-APRN-LIC-100 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
39646 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 9287298600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285066084 | Catherine Anne Kelly | Counselor | 102 Sea View Dr, Warwick, RI 02889-9229 | 2013-08-02 |
| 1548399983 | Catherine B. Kelly | Marriage & Family Therapist | 63 Chester Hill Rd, Warwick, NY 10990-2555 | 2007-03-03 |
| 1740893056 | Catherine Kelly | Nurse Practitioner | 1 Medical Center Dr, Morgantown, WV 26506-1200 | 2020-08-26 |
| 1558923516 | Catherine Kelly | Speech-Language Pathologist | 2425 E 71st St, Chicago, IL 60649-2612 | 2019-06-30 |
| 1528550001 | Catherine Jane Kelly | Student in an Organized Health Care Education/Training Program | 1 Medical Center Dr, Morgantown, WV 26506-1200 | 2018-05-31 |
| 1740791920 | Catherine Louise Kelly | Social Worker | 8130 Adams Dr, Hummelstown, PA 17036-8623 | 2017-10-16 |
| 1215455803 | Catherine Cailing Kelly | Marriage & Family Therapist | 1630 E Shaw Ave Ste 150, Fresno, CA 93710-8109 | 2017-09-02 |
| 1154844108 | Catherine Amanda Kelly | Nurse Practitioner | 11000 N Military Trl, Palm Beach Gardens, FL 33410-6504 | 2017-07-21 |
| 1326422999 | Catherine Kelly | Physical Therapist | 5690 Three Notch D Rd, Suite 107, Crozet, VA 22932-3172 | 2015-07-14 |
| 1225463409 | Catherine Jameson Lee Kelly | Psychologist | 11980 Mount Vernon Ave, Grand Terrace, CA 92313-5172 | 2013-09-06 |
| Street Address |
CORNER OF ROUTE N12 AND N7 |
| City | FORT DEFIANCE |
| State | AZ |
| Zip Code | 86504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326040577 | John R Thompson | Orthopaedic Surgery | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2005-06-01 |
| 1194348524 | Shanna Michelle George | Respiratory Therapist, Registered | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0589 | 2020-05-20 |
| 1265077267 | Stanislava Manojlovic | Pharmacist | Corner of Route N12 and N7, Fort Defiance Indian Hospital Board, Inc., Fort Defiance, AZ 86504-0649 | 2019-11-13 |
| 1033767371 | Dakota Kay | Physical Therapist | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2019-08-29 |
| 1053964452 | Jenny Dietz | Nurse Practitioner | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2019-07-24 |
| 1386296648 | Tessa Tahereh Facer | Physician Assistant | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2019-07-16 |
| 1346892056 | Amanda Barnes | Physician Assistant | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2019-07-12 |
| 1295206779 | Craig Amidon Fox | Physical Therapist | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2018-12-10 |
| 1134698517 | Christa Lee | Advanced Practice Midwife | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2018-11-15 |
| 1518440007 | Ethan Curleyhair | Dentist | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2018-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807664 | Clifford Charles | Pharmacist | Corners of Route 7&12, Fort Defiance, AZ 86504 | 2020-10-06 |
| 1720605207 | Christopher A Will | Registered Nurse | 2126-1 Shandiin Circle, Fort Defiance, AZ 86504 | 2020-06-30 |
| 1750904207 | Crystal Salaz | Respiratory Therapist, Registered | Corner of Roue N12 and N7, Fort Defiance, AZ 86504 | 2020-05-19 |
| 1003451600 | Rebecca Reeve | Pharmacist | Tsehootsooi Medical Center, Corner of Indian Route 7 and 12, Fort Defiance, AZ 86504 | 2019-11-07 |
| 1851947485 | David Glen Webb | Pharmacist | Hwy 12 Nr 110, Fort Defiance, AZ 86504 | 2019-08-09 |
| 1952963647 | Eukerison Bobby Tsinajinie | Counselor | .25 Miles S Fieldhouse Ra 6905, Fort Defiance, AZ 86504 | 2019-07-02 |
| 1770145567 | Joann Tso I | Counselor | 1/4 Mile Ne of Ft. Defiance Fieldhouse, Ft. Defiance, AZ 86504 | 2019-07-02 |
| 1174185961 | James Leslie | Counselor | 1/4 Mile South of Ft Defiance Fieldhouse Ra#6905, Ft Defiance, AZ 86504 | 2019-07-02 |
| 1184192163 | Miranda Frances Blatchford | Social Worker | .5 Miles Sw of The Fd Field House, Bldg #6905, Fort Defiance, AZ 86504 | 2018-11-07 |
| 1477030914 | Michelle Rosario | Dietitian, Registered | Fort Defiance Indian Hospital Board, Inc., Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2018-07-27 |
| Find all providers in zip 86504 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134203359 | Patricia Nadurak | Nurse Practitioner | Corner of N12 and N8, Fort Defiance, AZ 86504 | 2006-10-24 |
| 1255415451 | Stacy Ali | Nurse Practitioner | Corner Or North 7 and North 12, Fort Defiance, AZ 86504 | 2006-10-24 |
| 1558882084 | Byungyong Choi | Nurse Practitioner | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2017-07-06 |
| 1487187183 | Janet Kaercher | Nurse Practitioner | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2017-04-10 |
| 1831634997 | Darreika Dick | Nurse Practitioner | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2016-12-28 |
| 1891248571 | Karletta Dennis | Nurse Practitioner | Corner of Routes N12 & N7, Fort Defiance, AZ 86504 | 2016-07-28 |
| 1932570439 | Shatara Sherwood | Nurse Practitioner | Corner of Route N12 and N7, Tsehootsooi Medical Center, Fort Defiance, AZ 86504-0589 | 2015-10-12 |
| 1427455682 | Margaret Adams | Nurse Practitioner | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2014-12-03 |
| 1851631733 | Momodu Kamaru Oseni | Nurse Practitioner | Corner of Route N12 and N7, Fort Defiance Indian Hospital Board, Inc, Fort Defiance, AZ 86504-0649 | 2013-02-28 |
| 1538437611 | Kelly Aleen Haines | Nurse Practitioner | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2011-12-05 |
| Find all providers in FORT DEFIANCE | ||||
| City | FORT DEFIANCE |
| Zip Code | 86504 |
Please comment or provide details below to improve the information on CATHERINE GRACE KELLY.
| 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.