MRS. CAITLIN MARIE KELLY (NPI# 1629581970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629581970 |
| Entity Type | Individual |
| Full Name | MRS. CAITLIN MARIE KELLY |
| Other Name | MS. CAITLIN MARIE SHEARDY |
| Credential | AG-ACNP |
| Practice Address |
29001 Harper Ave Saint Clair Shores MI 48081-2711 |
| Mailing Address |
30025 Champine St Saint Clair Shores MI 48082-1653 |
| Practice Telephone | 5867780664 |
| Practice Fax Number | 5867780396 |
| Mailing Telephone | 5865040296 |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2019-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
4704299955 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453046 | Caitlin Kelly | Counselor | 484 W 43rd St Apt 23h, New York, NY 10036-6341 | 2019-08-22 |
| 1558860643 | Caitlin Patricia Brock Kelly | Counselor | 68 Mildorf St, Rochester, NY 14609-7230 | 2018-02-05 |
| 1114253309 | Caitlin Marie Kelly | Physician Assistant | 1755 Wittington Pl, Suite 800, Dallas, TX 75234-1927 | 2009-10-23 |
| 1053570770 | Caitlin Kelly | Social Worker | 14 Beech Hill Rd, Lloyd Harbor, NY 11743-1050 | 2008-06-06 |
| 1700409570 | Caitlin Harrison Kelly | Emergency Medicine | 28050 Grand River Ave, Farmington Hills, MI 48336-5919 | 2020-05-27 |
| 1235765397 | Caitlin Nora Kelly | Dance Therapist | 1339 York Ave, New York, NY 10021-4707 | 2020-03-20 |
| 1346701000 | Caitlin Marie Kelly | Behavioral Analyst | 620 N Robinson Dr, Robinson, TX 76706-5312 | 2019-03-26 |
| 1487156329 | Caitlin Kelly | Nurse Practitioner | 6100 Dobbin Rd, Columbia, MD 21045-5804 | 2018-03-07 |
| 1184152977 | Caitlin T Kelly | Optometrist | 484 County Line Rd W Ste 120, Westerville, OH 43082-7110 | 2017-05-24 |
| 1194178939 | Caitlin Maureen Kelly | Dentist | 131 Main St, Waltham, MA 02453-6636 | 2016-07-17 |
| Street Address |
29001 HARPER AVE |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081-2711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881650760 | Faten S Ayyoub | Internal Medicine | 29001 Harper Ave, Saint Clair Shores, MI 48081-2711 | 2006-04-21 |
| 1730570342 | Kidney Care Specialists of Michigan | Clinic/Center | 29001 Harper Ave, Saint Clair Shores, MI 48081-2711 | 2015-02-18 |
| 1821384249 | Jennifer Odren | Internal Medicine | 29001 Harper Ave, Saint Clair Shores, MI 48081-2711 | 2011-06-23 |
| 1588960298 | Kidney Care Specialists of Michigan PC | Internal Medicine | 29001 Harper Ave, Saint Clair Shores, MI 48081-2711 | 2011-01-28 |
| 1972771061 | Richard John Cross | Internal Medicine | 29001 Harper Ave, Saint Clair Shores, MI 48081-2711 | 2008-02-12 |
| 1720298136 | Blessing N. Okoronkwo | Internal Medicine | 29001 Harper Ave, Saint Clair Shores, MI 48081-2711 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
| 1669995783 | Terra Laquay Ginther | Social Worker | 28800 Harper Ave Ste A, Saint Clair Shores, MI 48081 | 2017-07-20 |
| 1245676998 | Julia Hanson | Social Worker | 27941 Harper Ave., Suite 105, St. Clair Shores, MI 48081 | 2013-05-21 |
| 1760731301 | Life Transition Service | Community/Behavioral Health | 21031 Sunnydale, St. Clair Shore, MI 48081 | 2012-08-29 |
| 1477868792 | William Burr Wood | Pharmacist | 21000 Twelve Milerd., St Clair Shores, MI 48081 | 2010-08-11 |
| 1508094350 | Dominic Anthony Garrisi | Anesthesiology | 21018 Bon Brae, St. Clair Shores, MI 48081 | 2009-06-30 |
| 1992947022 | Karen Ostrowski-thomas | Occupational Therapist | 22442 Bayview, St. Clair Shores, MI 48081 | 2009-04-06 |
| 1891979787 | Chirag Rachhadia | Physical Therapist | 29150 Harper Avenue, St. Clair Shores, MI 48081 | 2007-12-27 |
| 1598955114 | Donna Warner Manczak | Psychologist | 21400 E Eleven Mil Rd, St Clair Shores, MI 48081 | 2007-07-30 |
| 1467652347 | Sumit Narayanprasad Fogla | Family Medicine | 21400 E Eleven Mile Road, St. Clair Shores, MI 48081 | 2007-07-19 |
| Find all providers in zip 48081 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699296772 | Lance Raymond Woody | Nurse Practitioner | 22622 Oconnor St, Saint Clair Shores, MI 48080-4122 | 2017-06-29 |
| 1629133301 | Maria Gloria Pigon Schneider | Nurse Practitioner | 21631 Edmunton St, Saint Clair Shores, MI 48080-2314 | 2006-12-24 |
| 1669760070 | Fatme Barakat Coba | Nurse Practitioner | 24211 Little Mack Ave, Saint Clair Shores, MI 48080-1151 | 2011-07-19 |
| 1134435878 | Kianna Michelle Lyons | Nurse Practitioner | 28963 Little Mack Ave, 101, Saint Clair Shores, MI 48081-3017 | 2010-08-19 |
| 1790832319 | Marni Lynn Young | Nurse Practitioner | 24211 Little Mack Ave, Saint Clair Shores, MI 48080-1151 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759396 | Zainab Ali Hachem | Nurse Practitioner | 5158 Neckel St, Dearborn, MI 48126-3217 | 2020-10-29 |
| 1861092900 | Lindsay Overall | Nurse Practitioner | 1962 Sherlynn Dr, Brighton, MI 48114-7618 | 2020-10-28 |
| 1588289144 | Anne Elizabeth Stephan | Nurse Practitioner | 1320 Addington Ln, Ann Arbor, MI 48108-8951 | 2020-06-10 |
| 1447872965 | Gagan Preet Kaur Dhaliwal | Nurse Practitioner | 45418 Glengarry Blvd, Canton, MI 48188-3001 | 2020-05-07 |
| 1023637766 | Jbnp Services, LLC | Nurse Practitioner | 19520 Parker St, Livonia, MI 48152-1579 | 2020-04-13 |
| 1912536137 | Mary Bailey | Nurse Practitioner | 8254 Twin Creek Cir, Temperance, MI 48182-8202 | 2020-04-08 |
| 1679108500 | Jennifer Ann Rutzen | Nurse Practitioner | 5802 Montebello Ave, Haslett, MI 48840-8208 | 2020-03-11 |
| 1871126813 | Gregory M Ali | Nurse Practitioner | 26750 Providence Pkwy Ste 120, Novi, MI 48374-1211 | 2020-02-18 |
| 1730712969 | Anthony Joseph Jurecic | Nurse Practitioner | 2382 Us 41 W, Marquette, MI 49855-2456 | 2020-02-17 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48081 |
Please comment or provide details below to improve the information on MRS. CAITLIN MARIE 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.