KELLY MOTT WHITEHEAD (NPI# 1801442405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801442405 |
| Entity Type | Individual |
| Full Name | KELLY MOTT WHITEHEAD |
| Credential | FNP-C |
| Practice Address |
1902 Johnson St Jennings LA 70546-3628 |
| Mailing Address |
15361 Frederick Rd Iowa LA 70647-6358 |
| Practice Telephone | 3378249119 |
| Mailing Telephone | 3377893683 |
| Enumeration Date | 2019-08-11 |
| Last Update Date | 2019-08-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
207292 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528400298 | Kelly Whitehead | Occupational Therapist | 6800 Nw 39th Expy, Bethany, OK 73008-2513 | 2013-07-23 |
| Street Address |
1902 JOHNSON ST |
| City | JENNINGS |
| State | LA |
| Zip Code | 70546-3628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194828301 | Patrick W Griffith | Internal Medicine | 1902 Johnson St, Jennings, LA 70546-3628 | 2006-09-06 |
| 1265526446 | Jennings Internal Medicine Associates Inc. | Internal Medicine | 1902 Johnson St, Jennings, LA 70546 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295374593 | Skye Ringuet | Assistant Behavior Analyst | 611 North State St., Jennings, LA 70546 | 2020-01-03 |
| 1588120612 | Southern Home Care Services, Inc | Technician | 233 N. Main St., Jennings, LA 70546 | 2019-02-13 |
| 1902399249 | Calcasieu Urgent Care LLC | Clinic/Center | 1750 Elton Rd, Jennings, LA 70546 | 2018-06-12 |
| 1407308489 | Jefferson Davis Parish Council On Aging | Non-emergency Medical Transport (VAN) | 210 South State Street, Jennings, LA 70546 | 2016-10-26 |
| 1275906372 | Elizabeth Marie Ogea | Counselor | 203 E Academy Ave, Jennings, LA 70546 | 2015-11-11 |
| 1225401706 | Taylor Farris | Counselor | 1615 Johnston Street, Suite C, Jennings, LA 70546 | 2015-11-05 |
| 1134595622 | Karen Lynn Golla | Nurse Practitioner | 422 Kade Dr Ste 1, Jennings, LA 70546 | 2015-08-19 |
| 1326301615 | Lisa Turner | Registered Nurse | 403 Baker Street, Jennings, LA 70546 | 2012-06-21 |
| 1790057149 | Cenikor Foundation | Counselor | 222 E Academy, Suite A, Jennings, LA 70546 | 2012-02-01 |
| 1821328642 | Eric P Lambousy | Physical Therapist | 1322 Elton Road, Suite I, Jennings, LA 70546 | 2009-12-29 |
| Find all providers in zip 70546 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061950 | Kecia Clark | Nurse Practitioner | 3009 Englewood Dr, Jennings, LA 70546-3266 | 2020-10-19 |
| 1770056301 | Angela Renee Fontenot | Nurse Practitioner | 1322 Elton Rd Ste G, Jennings, LA 70546-4100 | 2019-01-07 |
| 1134595622 | Karen Lynn Golla | Nurse Practitioner | 422 Kade Dr Ste 1, Jennings, LA 70546 | 2015-08-19 |
| 1467730531 | Matthew Paul Vincent | Nurse Practitioner | 114 N Lake Arthur Ave, Jennings, LA 70546-5738 | 2011-07-23 |
| 1750305967 | Cathy Jane Cole | Nurse Practitioner | 1907 Johnson Street, Jennings Outpatient Clinic, Jennings, LA 70546-9998 | 2006-07-27 |
| 1205448651 | Leslie B Stelly | Nurse Practitioner | 1750 Elton Rd, Jennings, LA 70546-3632 | 2020-08-18 |
| 1003356627 | Christian Lewis | Nurse Practitioner | 1322 Elton Rd, Suite P, Jennings, LA 70546-4100 | 2017-03-01 |
| 1477961464 | Kristen Hanks | Nurse Practitioner | 1636 Elton Rd, Suite 204, Jennings, LA 70546-3648 | 2014-07-23 |
| 1760723266 | James Christopher Andries Jr. | Nurse Practitioner | 3330 N Frontage Rd, Jennings, LA 70546-3269 | 2013-03-07 |
| 1598019978 | Jill Angelle Breaux | Nurse Practitioner | 1322 Elton Rd, Suite F, Jennings, LA 70546-4100 | 2012-11-06 |
| Find all providers in JENNINGS | ||||
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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.