Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 889433 | TX |
NPI | 1003389784 |
---|---|
Provider Name | Mrs. Sherilyn Kelly |
First Address | North Las Vegas, NV 89086-1372 |
Second Address | Houston, TX 77054-1906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2019 |
Last Update Date | 06/01/2019 |