Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Coreen Kelly

Individual provider Nurse Practitioner · NPI 1790319994

Coreen Kelly is a Nurse Practitioner in Daytona Beach, Florida. Qualified in 2019, 7 years ago. Practices with Dna Center LLC, a 7-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2020
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1430 Mason Ave
Daytona Beach, FL 32117-4551
Phone: (386) 274-2000
Fax: (386) 274-2009
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APRN11006345 (FL)

Record details

NPI number1790319994
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 26, 2020
Last updated in NPPESNovember 19, 2024
Certification dateNovember 19, 2024
Mailing address1862 Silver Fern Rd, Port Orange, FL 32128-6741

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Dna Center Llc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Daytona Beach