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

Kelley Wise

Individual provider Family Medicine Physician · NPI 1023656600

Kelley Wise is a Nurse Practitioner in Palm Coast, Florida. Qualified in 2019, 7 years ago. Practices with Palm Harbor Family Practice and Walk-In Clinic, PA, a 7-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
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Practice location Address checks out

9 Pine Cone Dr Ste 102
Palm Coast, FL 32137-8683
Phone: (386) 445-6191
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence APRN11004755 (FL)

Record details

NPI number1023656600
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 14, 2019
Last updated in NPPESFebruary 7, 2021
Certification dateFebruary 7, 2021
Mailing address9 Pine Cone Dr Ste 102, Palm Coast, FL 32137-8683

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 Palm Harbor Family Practice And Walk-In Clinic, P.A — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Palm Coast