Provider Demographics
NPI:1730643842
Name:KAINA, KELLY ANN
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ANN
Last Name:KAINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15411 ARVIN DR
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34604-8197
Mailing Address - Country:US
Mailing Address - Phone:813-545-6572
Mailing Address - Fax:
Practice Address - Street 1:9550 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-4664
Practice Address - Country:US
Practice Address - Phone:727-494-7609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker