LISA KELLY (NPI# 1801187158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801187158 |
| Entity Type | Individual |
| Full Name | LISA KELLY |
| Credential | PA-C |
| Practice Address |
2740 N Hwy 360 Grand Prairie TX 75050-6403 |
| Mailing Address |
925 Wildwood Cir Grapevine TX 76051-6275 |
| Practice Telephone | 9726068300 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2014-05-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA05811 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164075453 | Lisa Marie Kelly | Nurse Practitioner | 10 E Front St Apt B, Monroe, MI 48161-2269 | 2019-07-16 |
| 1831752401 | Lisa A. Kelly | Social Worker | 23245 Brandywynne St, Southfield, MI 48033-4875 | 2019-04-18 |
| 1548734148 | Lisa Kelly | Counselor | 1601 E 4th Blvd., Vancouver, WA 98661 | 2019-01-16 |
| 1457728628 | Lisa Kelly | Psychologist | 11765 Hamilton Ave, Cincinnati, OH 45231-1128 | 2015-08-24 |
| 1558707828 | Lisa Kelly | Occupational Therapist | 8410 North Maple Avenue, Crystal River, FL 34428 | 2013-05-14 |
| 1417289935 | Lisa Catherine Kelly | Acupuncturist | 846 Ritchie Hwy, Suite 1a, Severna Park, MD 21146-4150 | 2010-02-09 |
| 1033342795 | Lisa Ann Kelly | Speech-Language Pathologist | 33 Winding Path, Apt 20, Manorville, NY 11949-2276 | 2009-08-28 |
| 1508019076 | Lisa Jean Kelly | Physical Therapy Assistant | 325 S Brookside Dr, Oxford, PA 19363-1192 | 2008-10-28 |
| 1952588154 | Lisa Maria Kelly | Family Medicine | 6006 Le Moyne Pass Ln, Missouri City, TX 77459-1762 | 2008-01-30 |
| 1720105711 | Lisa Ann Kelly | Speech-Language Pathologist | 459 Erickson Ct, Elburn, IL 60119-8990 | 2007-03-23 |
| Street Address |
2740 N HWY 360 |
| City | GRAND PRAIRIE |
| State | TX |
| Zip Code | 75050-6403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528063146 | Healthtexas Provider Network | Obstetrics & Gynecology | 2740 N Hwy 360, Suite 100, Grand Prairie, TX 75050-6401 | 2005-06-20 |
| 1013236652 | Elsie Manuel | Nurse Practitioner | 2740 N Hwy 360, Grand Prairie, TX 75050-6403 | 2010-05-21 |
| 1962636761 | Fundime Elmazi | Obstetrics & Gynecology | 2740 N Hwy 360, Grand Prairie, TX 75050-6403 | 2009-05-07 |
| 1053570226 | Guadalupe Reyna | Family Medicine | 2740 N Hwy 360, Suite 100, Grand Prairie, TX 75050-6403 | 2008-06-03 |
| 1154369155 | Molly Jane Boggs | Physician Assistant | 2740 N Hwy 360, Suite 100, Grand Prairie, TX 75050-6403 | 2006-06-02 |
| 1043266711 | Susan Renee Carlson | Nurse Practitioner | 2740 N Hwy 360, Suite 100, Grand Prairie, TX 75050-6403 | 2006-05-25 |
| 1407802259 | James David Peters | Obstetrics & Gynecology | 2740 N Hwy 360, Suite 100, Grand Prairie, TX 75050-6403 | 2006-05-25 |
| 1396798393 | Sean Henri Neufeldt | Nurse Practitioner | 2740 N Hwy 360, Suite 100, Grand Prairie, TX 75050-6403 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225539695 | Christopher Bachman | Physical Therapy Assistant | 2045 Hwy 360, #100b, Grand Prarie, TX 75050 | 2018-02-21 |
| 1003335233 | L & B Group Home LLC | In Home Supportive Care | 605 E Palace Pkwy Ste, B4, Grand Prairie, TX 75050 | 2017-09-19 |
| 1073054748 | Smileeasy Dental Grand Prairie, Pllc | Dentist | 2650 S Hwy 161, Grand Prairie, TX 75050 | 2017-03-15 |
| 1164966651 | Prime Diagnostic Imaging of Irving, LLC | Clinic/Center | 2210 Paddock Way, Grand Prairie, TX 75050 | 2016-12-19 |
| 1366801037 | Monica Simpson | Counselor | 2080 N Hwy 360, Ste 430, Grand Prairie, TX 75050 | 2016-02-23 |
| 1437545845 | Stateserv Medical of Texas | Durable Medical Equipment & Medical Supplies | 1000 Post and Paddock Street, #305, Grand Prairie, TX 75050 | 2015-04-13 |
| 1912304593 | Tenishia Chintankwa | Non-emergency Medical Transport (VAN) | 2403 Doreen St, Grand Prairie, TX 75050 | 2014-11-26 |
| 1780023192 | Holland Surgical Group | Physician Assistant | 201 West Tarrant Rd. #1420, Grand Prairie, TX 75050 | 2013-06-19 |
| 1174962823 | Occumed Plus-grand Prairie | General Practice | 805 W. North Carrier Pkwy, 260, Grand Prairie, TX 75050 | 2013-06-17 |
| 1497099618 | Sorai Susanne S Stuart | Counselor | 2825 N. State Hwy 360, 710, Grand Prairie, TX 75050 | 2012-11-15 |
| Find all providers in zip 75050 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275710261 | Southwest Home Medical Care Services, Pllc | Physician Assistant | 2012 Kalgary Ln, Grand Prairie, TX 75052-8869 | 2008-01-22 |
| 1962881441 | Dfw Family Clinic | Physician Assistant | 2771 Sherman St, Grand Prairie, TX 75051-6016 | 2015-05-29 |
| 1194046797 | Lisa Jean Barnes | Physician Assistant | 2709 Hospital Blvd, Grand Prairie, TX 75051-1017 | 2010-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
| 1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
| 1497384168 | Gregory C Etienne | Physician Assistant | 7400 N 4th St, Mcallen, TX 78504-1859 | 2020-04-05 |
| 1689202475 | Theodore Inthaphom | Physician Assistant | 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065 | 2020-03-29 |
| 1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
| 1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
| 1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
| 1730728528 | Holli Marie Beard | Physician Assistant | 2625 Scripture St Ste 101, Denton, TX 76201-2304 | 2019-12-27 |
| 1477191237 | Ronald Edwin Brown | Physician Assistant | 1427 Cypress Point Dr, Gunter, TX 75058-3201 | 2019-12-11 |
| 1053957910 | Rossalya Aracely Granda Gutierrez | Physician Assistant | 4150 N Collins St, Arlington, TX 76005-4547 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
| City | GRAND PRAIRIE |
| Zip Code | 75050 |
Please comment or provide details below to improve the information on LISA 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.