{"npi":"1336388982","type":"NPI-1","status":"active","name":{"display":"Kelly Pietan CRNA","other":[],"first":"KELLY","last":"PIETAN","middle":"LYNN","credential":"CRNA"},"specialty":{"primary_taxonomy":"367500000X","primary_taxonomy_description":"Certified Registered Nurse Anesthetist","slug":"certified-registered-nurse-anesthetist","schema_org_specialty":null,"all":[{"code":"367500000X","description":"Certified Registered Nurse Anesthetist","primary":true,"state":"FL","license":"ARNP9184815"}]},"addresses":[{"purpose":"LOCATION","street_1":"655 W 8TH ST","city":"JACKSONVILLE","state":"FL","postal_code":"322096511","country_code":"US","street_2":"UFJAX - DEPT. OF ANESTHESIOLOGY","phone":"9042444195","fax":"9042444908"},{"purpose":"MAILING","street_1":"PO BOX 44008","city":"JACKSONVILLE","state":"FL","postal_code":"322314008","country_code":"US","street_2":"UFJP - PROVIDER ENROLLMENT","phone":"9042443199","fax":"9042443425"}],"license":{"state":"FL","number":"ARNP9184815"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"602083230C","state":"FL","issuer":null},{"type_code":"05","label":"Medicaid","value":"602083230B","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"0007980-00","state":"FL","issuer":null},{"type_code":"05","label":"Medicaid","value":"602083230A","state":"GA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20090317000491","type_code":"14-43","type_desc":"PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)","state":"FL","pac_id":"5698832723"}]},"enumeration_date":"2009-02-05","last_updated":"2015-12-23","_meta":{"source":"NPPES","snapshot_date":"2015-12-23","doc_url":"https://findmynpi.com/api"}}