Individual provider · Type 1 NPI
Brian Ismael Kelly, NP
Nurse Practitioner · Stockton, CA
Practice location
525 W Acacia St
Stockton, CA 95203-2405
Mailing address
6701 Shorewood Ln
Stockton, CA 95219-7004
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 95184031 (CA) |
| Nurse Practitioner Primary | 363L00000X | 95184031 (CA) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1407649957
Brian Ismael Kelly, NP's National Provider Identifier is 1407649957, issued on May 27, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Stockton, CA. The record was last updated on Jul 26, 2025.