KAITLYN KELLY FNP-BC
NPI 1124793757
Nurse Practitioner - Family in Staten Island, NY

Q: What is Kaitlyn Kelly's NPI number?

The NPI number for Kaitlyn Kelly is 1124793757. It was assigned to this individual provider in the NPPES registry on August 16, 2021.

Q: What is Kaitlyn Kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kaitlyn Kelly was last updated on August 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 16, 2021

41 WALKER ST, STATEN ISLAND, NY 10302(646) 591-0563 Get Directions Write a Review

NPPES record last updated: August 16, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kaitlyn Kelly Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAITLYN KELLY FNP-BC (NPI 1124793757) is an individual family provider in Staten Island, New York, licensed in New York (F347253-01) and active in the NPI registry since August 2021. She maintains a secondary practice location in Staten Island.

NPPES Registry Identity

NPI1124793757

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKAITLYN KELLYCredential: FNP-BC

Location Address41 WALKER STStaten Island, NY 10302-1658

Mailing Address41 Walker StStaten Island, NY 10302-1658

Phone(646) 591-0563

Sole ProprietorNo

Enumeration DateAugust 16, 2021

NPPES CertifiedAugust 16, 2021

✔ NPI 1124793757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NY · F347253-01

41 WALKER ST, Staten Island, NY 10302

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Secondary Practice Location 1

Location 141 Walker StStaten Island, NY 10302-1658

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kaitlyn Kelly's NPI number?

The NPI number for Kaitlyn Kelly is 1124793757. It was assigned to this individual provider in the NPPES registry on August 16, 2021.

Where is Kaitlyn Kelly located?

Kaitlyn Kelly practices at 41 Walker St, Staten Island, NY 10302. The listed phone number is (646) 591-0563.

What is Kaitlyn Kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Kaitlyn Kelly was last updated on August 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.