Marypat Kelly
Nurse Practitioner - Gerontology
80 Great Oaks Blvd
San Jose
, California 95119-1310
Marypat Kelly
Nurse Practitioner - Gerontology
80 Great Oaks Blvd
San Jose
, California 95119-1310
(650) 473-0529
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Marypat Kelly
- 1150 Pine St
- Menlo Park, CA
- Zip : 94025-3455
- Phone : (650) 473-0529
Second Address
- Marypat Kelly
- 80 Great Oaks Blvd
- San Jose, CA
- Zip : 95119-1310
- Fax : (408) 363-3082
- Phone : (408) 363-3000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 15112 | CA |
National Provider Identifier
| NPI | 1043289523 |
|---|---|
| Provider Name | Marypat Kelly |
| First Address | Menlo Park, CA 94025-3455 |
| Second Address | San Jose, CA 95119-1310 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/03/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.