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General NPI Number Information
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NPI Number | 1588583348
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Entity Type | Individual
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Provider Name | KAYLEEN LIANNE MESA FNP
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Gender | Female
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 550 N BROAD ST
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City | ELIZABETH
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State | NJ
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Zip | 07208-3302
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Country | US
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Telephone | 908-344-9644
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Fax | 908-344-5000
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Provider Business Mailing Address
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Address Line | 550 N BROAD ST
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City | ELIZABETH
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State | NJ
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Zip | 07208-3302
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Country | US
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Telephone | 908-344-9644
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Fax | 908-344-5000
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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 | N45299-01
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License Number State | NY
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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 | 26NJ15604400
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License Number State | NJ
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