KELLI KRISTIANA GRADY (NPI# 1922664762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922664762 |
| Entity Type | Individual |
| Full Name | KELLI KRISTIANA GRADY |
| Credential | APRN |
| Practice Address |
4880 N Highway 19a Ste 200 Mount Dora FL 32757-2018 |
| Mailing Address |
2023 Tournament Dr Apopka FL 32712-2022 |
| Practice Telephone | 3525898111 |
| Mailing Telephone | 8132300455 |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2019-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
11001066 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4880 N HIGHWAY 19A STE 200 |
| City | MOUNT DORA |
| State | FL |
| Zip Code | 32757-2018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225338965 | Kayce Ann Walker | Nurse Practitioner | 4880 N Highway 19a Ste 200, Mount Dora, FL 32757-2018 | 2010-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093324824 | Cypress Grove Counseling Center LLC | Counselor | 6551 N Orange Blossom Trail Suite 209 #1005, Mount Dora, FL 32757 | 2020-07-28 |
| 1790327286 | Alisha Dawn Bateman | Nurse Practitioner | 7678 Lake Ola Dr., Mount Dora, FL 32757 | 2019-10-16 |
| 1306496153 | Carehere LLC | Family Medicine | Carehere Clinic- City of Mount Dora, Fl, 2110 North Donnelly Street, Mt Dora, FL 32757 | 2019-09-13 |
| 1871008680 | Sonya Quiroz | Behavior Technician | 21038 Niles Ave, Mount Dora, FL 32757 | 2017-12-04 |
| 1043737661 | Erin N Booth | Behavior Technician | 411 N. Donnelly St., Suite 307, Mount Dora, FL 32757 | 2017-08-24 |
| 1053850073 | Sunshine Recovery Network, Inc | Community/Behavioral Health | 632 E 5th Ave, Mount Dora, FL 32757 | 2017-02-23 |
| 1336684661 | Catherine Lim Panlilio | Physical Therapist | 300 Brookfield Avenue, Mount Dora, FL 32757 | 2016-12-22 |
| 1659815306 | Mount Dora Modern Dentistry, Pa | Dentist | 17365 Us Hwy 441, Eustis, FL 32757 | 2016-12-15 |
| 1447603303 | Lake County Adult Activity Center Inc | Respite Care | 1934 N Donnelly St, Suite B, Mount Dora, FL 32757 | 2016-07-15 |
| 1871955724 | Sagir Patel | Dentist | 17365 Us Highway 441, Mount Dora, FL 32757 | 2016-03-22 |
| Find all providers in zip 32757 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205130457 | Daybreak Pediatric Housecalls, P.a. | Nurse Practitioner | 925 Northside Dr, Mount Dora, FL 32757-2610 | 2011-01-03 |
| 1225338965 | Kayce Ann Walker | Nurse Practitioner | 4880 N Highway 19a Ste 200, Mount Dora, FL 32757-2018 | 2010-10-28 |
| 1033143672 | Carol J Kirkland | Nurse Practitioner | 4880 N Highway 19a, Suite 200, Mount Dora, FL 32757-2018 | 2006-07-10 |
| 1427306745 | Sharlene Hope Smith | Nurse Practitioner | 4880 N Highway 19a, Suite 200, Mount Dora, FL 32757-2018 | 2012-08-16 |
| 1104013036 | Anna Nora Walls | Nurse Practitioner | 4880 N Highway 19a, Suite 200, Mount Dora, FL 32757-2018 | 2007-09-25 |
| 1760590731 | Gail Ann Carlson | Nurse Practitioner | 4880 N Highway 19a, Suite 200, Mount Dora, FL 32757-2018 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417072 | Carmen Moreno | Nurse Practitioner | 336 Golfview Rd Apt 909, North Palm Beach, FL 33408-3512 | 2020-11-05 |
| 1366043614 | Christi Koshy | Nurse Practitioner | 4025 N Nob Hill Rd Apt 207, Sunrise, FL 33351-5811 | 2020-11-03 |
| 1730789322 | Michelle Yen-vera | Nurse Practitioner | 18409 Nw 9th Ct, Pembroke Pines, FL 33029-3607 | 2020-11-01 |
| 1376143487 | Aimee N Jorgenson Stough | Nurse Practitioner | 91550 Overseas Hwy Ste 209, Tavernier, FL 33070-2513 | 2020-10-28 |
| 1588271233 | Olivia Janelle De Jong | Nurse Practitioner | 424 Ne 6th St Apt D, Gainesville, FL 32601-5576 | 2020-09-28 |
| 1801407796 | Elisabeth Morley Chinlund | Nurse Practitioner | 445 Delmar Ter S Apt 5, Saint Petersburg, FL 33701-4653 | 2020-08-13 |
| 1972113025 | Nicole Horn | Nurse Practitioner | 8095 Spyglass Hill Rd Ste 104, Melbourne, FL 32940-8290 | 2020-08-04 |
| 1073131850 | Olivia Dawn Wilson | Nurse Practitioner | 5105 Clover Mist Dr, Apollo Beach, FL 33572-3417 | 2020-07-08 |
| 1427687565 | Cortney M Starr | Nurse Practitioner | 2261 Kingfisher Ln, Clearwater, FL 33762-3323 | 2020-04-01 |
| 1285263335 | Summer Leigh Moran | Nurse Practitioner | 528 W Baldwin Rd # A, Panama City, FL 32405-3313 | 2020-04-01 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT DORA |
| Zip Code | 32757 |
Please comment or provide details below to improve the information on KELLI KRISTIANA GRADY.
| 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.