| Doctor Name: | KELLEY ELAINE PENNELL |
| NPI Number: | 1255516944 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNS |
| License Number: | 709818 |
| Business Practice Address: | 5000 Schertz Pkwy Ste 400 Schertz, TX - 781541457 |
| Business Phone Number: | 2104957246 |
| Business Fax Number: | 2104957245 |
| Mailing Address: | Po Box 117475, CARROLLTON |
| State: | TX |
| Postal Code: | 750117475 |
| Phone Number: | 2104957246 |
| Fax Number: | 2104957245 |
| NPI Enumeration Date: | 01/01/2008 |
| NPI Last Update Date: | 05/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SA2200X |
| License Number: | 709818 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |