Healthcare Provider Details

I. General information

NPI: 1891232310
Provider Name (Legal Business Name): PATRICIA MARIE ARENELLA KELLY DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2017
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date: 09/08/2025
Reactivation Date: 12/04/2025

III. Provider practice location address

2072 ELKINS POINT DR
MELBOURNE FL
32935-7800
US

IV. Provider business mailing address

2072 ELKINS POINT DR
MELBOURNE FL
32935-7800
US

V. Phone/Fax

Practice location:
  • Phone: 407-242-5788
  • Fax:
Mailing address:
  • Phone: 407-242-5788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11041417
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9437974
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: