Healthcare Provider Details

I. General information

NPI: 1568357614
Provider Name (Legal Business Name): KELLY MONROE PATRICK DNP, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 PARNASSUS AVE
SAN FRANCISCO CA
94143-2206
US

IV. Provider business mailing address

3 OLD ACRES RD
MOODUS CT
06469-1261
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-3785
  • Fax:
Mailing address:
  • Phone: 203-623-7425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA95002877
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number14875
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: