MARY ANN HETTICH-KELLY (NPI# 1790810257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790810257 |
| Entity Type | Individual |
| Full Name | MARY ANN HETTICH-KELLY |
| Other Name | MARY ANN HETTICH |
| Credential | APRN CNS PSYCH |
| Practice Address |
107 Commercial St Mashpee MA 02649-6507 |
| Practice Telephone | 5084777090 |
| Practice Fax Number | 5084777028 |
| Mailing Telephone | 5084777090 |
| Mailing Fax Number | 5084777028 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2015-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0812X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Community |
197116 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
107 COMMERCIAL ST |
| City | MASHPEE |
| State | MA |
| Zip Code | 02649-6507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142504 | Kenneth George Terkelsen | Psychiatry & Neurology | 107 Commercial St, Mashpee, MA 02649-6507 | 2005-05-23 |
| 1689283368 | Alyssa Caggiano | Nurse Practitioner | 107 Commercial St, Mashpee, MA 02649-6507 | 2020-07-28 |
| 1780226258 | Susan Hart | Social Worker | 107 Commercial St, Mashpee, MA 02649-6507 | 2019-10-16 |
| 1336791680 | Emily Elgert | Nurse Practitioner | 107 Commercial St, Mashpee, MA 02649-6507 | 2019-07-16 |
| 1730684275 | Community Health Center of Cape Cod, Inc. | Clinic/Center | 107 Commercial St, Mashpee, MA 02649-6507 | 2018-03-27 |
| 1922501824 | Aaron Maloy | Nurse Practitioner | 107 Commercial St, Mashpee, MA 02649-6507 | 2018-03-16 |
| 1518491919 | Natasha Fonseca Barbosa-fortes | Dentist | 107 Commercial St, Mashpee, MA 02649-6507 | 2017-04-12 |
| 1760933014 | Cheri Lynne Cerrato | Nurse Practitioner | 107 Commercial St, Mashpee, MA 02649-6507 | 2016-10-21 |
| 1588112304 | Erica Urban | Counselor | 107 Commercial St, Mashpee, MA 02649-6507 | 2016-09-21 |
| 1972050029 | Dena Irwin | Dietitian, Registered | 107 Commercial St, Mashpee, MA 02649-6507 | 2016-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457817348 | Emily Hannah Minakin | Physician Assistant | Community Health Center of Cape Cod, 107 Commercial Street, Mashpee, MA 02649 | 2019-02-15 |
| 1790278018 | Westwind Counseling & Wellness, LLC | Counselor | 681 Falmouth Rd Ste A20c, Mashpee, MA 02649 | 2018-06-11 |
| 1790151967 | Katie Justine Wallace | Nurse Practitioner | Mashpee Family Medicine 5 Industrial Drive, Suite 100, Mashpee, MA 02649 | 2015-08-11 |
| 1972847689 | Kara M Blackwell | Licensed Practical Nurse | 12 Pine Grove Circle, Mashpee, MA 02649 | 2012-11-19 |
| 1992001457 | Mashpee Service Unit/indian Health Service | Clinic/Center | 483 Great Neck Road South, Building 002-health Clinic, Mashpee, MA 02649 | 2011-02-01 |
| 1306178066 | Pamela W Brighton | Counselor | Mashpee Common 2 Oak St., Center for Family Therapy, Mashpee, MA 02649 | 2010-02-05 |
| 1063743524 | Shana M Truel | Counselor | 477 Main Street, Mashpee, MA 02649 | 2010-01-22 |
| 1376718197 | Christopher Joseph Salvo | Pediatrics | 107 Commercial St., Mashpee, MA 02649 | 2008-04-23 |
| 1215111489 | Joyce Teir Hosford | Speech-Language Pathologist | 418-88 Quinaquisset Ave., Mashpee, MA 02649 | 2007-12-24 |
| 1225218092 | Emily Davern | Social Worker | 107 Commerical St, Mashpee, MA 02649 | 2007-11-09 |
| Find all providers in zip 02649 | ||||
| Taxonomy Code | 364SP0812X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Community |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861681934 | Alexander J Scerbo | Clinical Nurse Specialist | 130 Marshall Rd, Lowell Cboc, Lowell, MA 01852-5130 | 2007-10-15 |
| 1760506893 | Eileen R Farrell | Clinical Nurse Specialist | 1 Washington St, Taunton, MA 02780-3960 | 2007-03-16 |
Please comment or provide details below to improve the information on MARY ANN HETTICH-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.