KELLI M. TYSON (NPI# 1801304357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801304357 |
| Entity Type | Individual |
| Full Name | KELLI M. TYSON |
| Credential | ARNP |
| Practice Address |
3550 University Blvd. S. Ste 302 Jacksonville FL 32216 |
| Practice Telephone | 9047334444 |
| Practice Fax Number | 9047335377 |
| Mailing Telephone | 9047334444 |
| Mailing Fax Number | 9047335377 |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-01-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | ARNP9229212 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3550 UNIVERSITY BLVD. S. STE 302 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| 1356889232 | Sheila Casabar | Registered Nurse | 3615 University Blvd S, Jacksonville, FL 32216 | 2017-02-10 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639786338 | Bernardo C Lobusta Jr. | Nurse Practitioner | 13500 Sutton Park Dr S Ste 504, Jacksonville, FL 32224-5290 | 2020-09-26 |
| 1720695513 | Kristin Browning | Nurse Practitioner | 1260 Mcduff Ave S # 4, Jacksonville, FL 32205-8030 | 2020-09-25 |
| 1780295667 | Sharnice Letia White | Nurse Practitioner | 11751 Lake Bend Cir, Jacksonville, FL 32218-9057 | 2020-08-13 |
| 1891305082 | Kayla Susan Weller | Nurse Practitioner | 4361 Gadsden Ct, Jacksonville, FL 32207-6218 | 2020-08-03 |
| 1952925315 | Michelle Benefield | Nurse Practitioner | 605 W Beaver St, Jacksonville, FL 32202-4722 | 2020-06-02 |
| 1831739887 | Melanie Bautista | Nurse Practitioner | 4540 Southside Blvd Ste 401, Jacksonville, FL 32216-5488 | 2020-01-07 |
| 1235776279 | Janine Mancusi | Nurse Practitioner | 417 Brody Cove Trl, Jacksonville, FL 32225-5113 | 2019-12-10 |
| 1114576881 | Delesa Gabrielle Bradley | Nurse Practitioner | 1602 S Jackson St, Jacksonville, TX 75766-3028 | 2019-09-05 |
| 1508411190 | Jaclyn Michelle Bowden | Nurse Practitioner | 6930 Bonneval Rd Ste 2, Jacksonville, FL 32216-6084 | 2019-08-09 |
| 1386297414 | Rebecca Newell | Nurse Practitioner | 3151 Blue Heron Dr N, Jacksonville, FL 32223-2706 | 2019-07-17 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
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| 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.