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General NPI Number Information
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NPI Number | 1932784105
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Entity Type | Individual
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Provider Name | ALYXANDREA MARIE KELLY PMHNP
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Gender | Female
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 1175 CARONDELET DR
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City | RICHLAND
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State | WA
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Zip | 99354-3300
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Country | US
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Telephone | 509-943-9104
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Fax |
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Provider Business Mailing Address
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Address Line | 2637 TORREY PINES WAY
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City | RICHLAND
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State | WA
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Zip | 99354-2380
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Country | US
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Telephone | 231-970-0460
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP20122031
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704313495
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2024000884
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN60951415
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License Number State | WA
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