Provider Demographics
NPI:1053703017
Name:RECCHIA, KELLY RAE (DNP, ARNP-BC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:RAE
Last Name:RECCHIA
Suffix:
Gender:F
Credentials:DNP, ARNP-BC
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:RAE
Other - Last Name:SAXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, ARNP-BC
Mailing Address - Street 1:101 GASTON COURT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436
Mailing Address - Country:US
Mailing Address - Phone:954-650-9864
Mailing Address - Fax:
Practice Address - Street 1:4205 W ATLANTIC AVE STE 201
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3901
Practice Address - Country:US
Practice Address - Phone:561-638-9140
Practice Address - Fax:561-498-0320
Is Sole Proprietor?:No
Enumeration Date:2015-02-28
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9313601363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily