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General NPI Number Information
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NPI Number | 1801786173
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Entity Type | Individual
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Provider Name | HANNAH REBECCA KELLY RN, BAN, ARNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 105 E MAIN ST
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City | WAUKON
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State | IA
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Zip | 52172-1735
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Country | US
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Telephone | 563-568-5530
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Fax |
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Provider Business Mailing Address
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Address Line | 1322 315TH AVE
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City | FORT ATKINSON
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State | IA
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Zip | 52144-7112
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Country | US
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Telephone | 563-568-9653
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Fax | 563-568-9653
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 176661
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License Number State | IA
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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 | A185428
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License Number State | IA
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