Doctor Name: | MISS CHERYL ANN KELLEY |
NPI Number: | 1306838602 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 240740 |
Business Practice Address: | 5311 Big Spring Hwy Snyder, TX - 795496347 |
Business Phone Number: | 3257762500 |
Business Fax Number: | 3257762355 |
Mailing Address: | 1407 Sunnyvale St, SWEETWATER |
State: | TX |
Postal Code: | 795561922 |
Phone Number: | 3259334224 |
Fax Number: | |
NPI Enumeration Date: | 08/22/2005 |
NPI Last Update Date: | 12/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 240740 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |