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Jacqueline Kelly

NPI 1235077694ActiveIndividual· Nurse Practitioner, Family· Lakeport, CA

Nurse Practitioner, Family with Sutter Bay Hospitals and 1 other group, practicing in Lakeport, California. Enrolled in Medicare as practitioner - nurse practitioner. Lists Sutter Lakeside Hospital as a hospital affiliation.

Overview

NPI1235077694
StatusActive
Entity typeIndividual
Sole proprietorNo
NPI issuedMar 24, 2026
Last updated in NPPESMar 24, 2026
Certified by providerMar 24, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Nurse Practitioner, Family Primary363LF0000XF02260054CA

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Nurse Practitioner (CA)

Medicare sources and data years

Education and affiliations

Graduation year2025
Medicare specialtyNurse Practitioner

Medical groups

Hospital affiliation

Source: CMS Care Compare

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Nurse Practitioner, Family providers in Lakeport

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