Healthcare Provider Details

I. General information

NPI: 1861698664
Provider Name (Legal Business Name): KELLY R HOST NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY H PARSONS NP

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MEADE PKWY
SUFFOLK VA
23434-4259
US

IV. Provider business mailing address

PO BOX 7068
PORTSMOUTH VA
23707-0068
US

V. Phone/Fax

Practice location:
  • Phone: 757-539-0251
  • Fax: 757-539-7523
Mailing address:
  • Phone: 757-686-3508
  • Fax: 757-686-0541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001180236
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0024167399
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: