Provider Demographics
NPI:1740586288
Name:BATTILLO, KELLIE KILPATRICK (FNP-C, ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KELLIE
Middle Name:KILPATRICK
Last Name:BATTILLO
Suffix:
Gender:F
Credentials:FNP-C, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 S ST ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3857
Mailing Address - Country:US
Mailing Address - Phone:321-662-6686
Mailing Address - Fax:
Practice Address - Street 1:76 S ST ANDREWS DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-3857
Practice Address - Country:US
Practice Address - Phone:321-662-6686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9179951363LF0000X
FLAPRN9179951363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily