Individual provider · Type 1 NPI

Marypat Kelly, GNP

Gerontology Nurse Practitioner · San Jose, CA

NPI number 1043289523 Active

Practice location

80 Great Oaks Blvd
San Jose, CA 95119-1310

Fax (408) 363-3082

Mailing address

1150 Pine St
Menlo Park, CA 94025-3455

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600X15112 (CA)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1043289523

Marypat Kelly, GNP's National Provider Identifier is 1043289523, issued on Mar 16, 2006. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in San Jose, CA. The record was last updated on Jul 13, 2026.