SERENA LEIGH KELLEY (NPI# 1710494042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710494042 |
| Entity Type | Individual |
| Full Name | SERENA LEIGH KELLEY |
| Practice Address |
107 Diamond Ave Se Apt 1 Grand Rapids MI 49506-1407 |
| Practice Telephone | 8126032309 |
| Mailing Telephone | 8126032309 |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-01-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 5302043816 | MI | Student, Health Care |
| Street Address |
107 DIAMOND AVE SE APT 1 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49506-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954705 | Mckenna Shank | Technician | 1409 E Beltline Ave Se, Grand Rapids, MI 49506 | 2020-08-26 |
| 1750917969 | Meghan Elizabeth Southwell | Social Worker | Counseling Center of West Michigan, 360 East Beltline Ave Ne Suite 100, Grand Rapids, MI 49506 | 2020-03-19 |
| 1356876536 | Lisa Finkbeiner | Chiropractor | 1324 Lake Dr Se Ste 1, Grand Rapids, MI 49506 | 2017-04-26 |
| 1447622964 | Ashley Robinson | Rehabilitation Practitioner | 1490 East Beltline Ave, Grand Rapids, MI 49506 | 2015-10-23 |
| 1770951584 | Stuart Segal | Behavioral Analyst | 1415 Wealthy St Se Apt 312, Grand Rapids, MI 49506 | 2015-09-10 |
| 1922476373 | Elizabeth Taylor | Nurse Practitioner | 2255 Wealthy Dr., Grand Rapids, MI 49506 | 2015-09-02 |
| 1780066092 | Carole Walters Counseling | Social Worker | 959 Wealthy St. Se, Grand Rapids, MI 49506 | 2015-06-23 |
| 1053792697 | Rosemary F. Trimpe | Social Worker | 4255 Kalamazoo Se, Grand Rapids, MI 49506 | 2015-06-09 |
| 1164809919 | Gary James | Rehabilitation Practitioner | 1490 E. Beltline Se, Grand Rapids, MI 49506 | 2015-04-30 |
| 1275925315 | Paul Cole | Counselor | 1101 Ball Ave. .se., Grand Rapids, MI 49506 | 2015-02-26 |
| Find all providers in zip 49506 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194348813 | Holly Beth Myer | Student in an Organized Health Care Education/Training Program | 2615 3 Mile Rd Ne, Grand Rapids, MI 49525-3944 | 2020-05-28 |
| 1649890559 | Kelsey Anne Knowles | Student in an Organized Health Care Education/Training Program | 2088 Watermark Dr Se, Grand Rapids, MI 49546-9012 | 2020-04-21 |
| 1174142285 | Jeremy David Mormol | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne Ste 501, Grand Rapids, MI 49503-2560 | 2020-04-09 |
| 1417586454 | Ashutosh Agrawal | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne # Mc46, Grand Rapids, MI 49503-2560 | 2020-04-02 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1942858048 | Kyle Brandon Avery | Student in an Organized Health Care Education/Training Program | 223 Prospect Ave Ne, Grand Rapids, MI 49503-5649 | 2019-09-01 |
| 1487209516 | Kathryn Ann Pilczuk | Student in an Organized Health Care Education/Training Program | 333 Bridge St Nw, Grand Rapids, MI 49504-5367 | 2019-08-06 |
| 1831752443 | Mark Pressler | Student in an Organized Health Care Education/Training Program | 15 Michigan St Ne, Grand Rapids, MI 49503-2509 | 2019-04-18 |
| 1043774177 | Rebecca Elyse Mitchell | Student in an Organized Health Care Education/Training Program | 932 Fulton St E Apt 1, Grand Rapids, MI 49503-3565 | 2019-01-23 |
| 1841767712 | Jordon Alexander Wurst-smith | Student in an Organized Health Care Education/Training Program | 44 Indiana Ave Nw, Grand Rapids, MI 49504-6369 | 2018-10-30 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49506 |
Please comment or provide details below to improve the information on SERENA LEIGH KELLEY.
| 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.