Individual provider · Type 1 NPI

Kelly Carroll, DNP

Nurse Practitioner · San Diego, CA

NPI number 1447135397 Active

Practice location

1550 Broadway
San Diego, CA 92101-5713

Call (619) 515-2525 Map

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541

Specialties and licenses

Taxonomy	Code	License
Nurse Practitioner Primary	363L00000X	95035463 (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 1447135397

Kelly Carroll, DNP's National Provider Identifier is 1447135397, issued on Aug 8, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in San Diego, CA. The record was last updated on Nov 4, 2025.