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General NPI Number Information
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NPI Number | 1285107318
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Entity Type | Individual
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Provider Name | TALPHINETA ALISHA KELLY NP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/11/2019
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 346 KYLAR DR NW
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City | PALM BAY
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State | FL
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Zip | 32907-6825
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Country | US
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Telephone | 719-492-9077
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Fax | 719-492-9077
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Provider Business Mailing Address
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Address Line | 346 KYLAR DR NW
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City | PALM BAY
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State | FL
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Zip | 32907-6825
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Country | US
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Telephone | 719-492-9077
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 202029
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 902999
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP030650
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 299338
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 101.0136821
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License Number State | VT
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0101702-C-NP
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License Number State | CO
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 78895
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License Number State | ID
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11017247
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License Number State | FL
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