Individual provider · Type 1 NPI
Tenesha Shanta Kelly-Roberts, FNP-C
Family Nurse Practitioner · New York, NY
NPI number
1114733417
Active
Practice location
1468 Madison Ave
New York, NY 10029-6508
Mailing address
10 Wisteria Dr Apt 3C
Fords, NJ 08863-1130
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 491143 (NY) |
| Family Nurse Practitioner Primary | 363LF0000X | F355613-01 (NY) |
Family Nurse Practitioner: Definition to come...
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About NPI 1114733417
Tenesha Shanta Kelly-Roberts, FNP-C's National Provider Identifier is 1114733417, issued on Dec 10, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in New York, NY. The record was last updated on Jun 11, 2026.