Healthcare Provider Details

I. General information

NPI: 1871733634
Provider Name (Legal Business Name): KELLY LANE TURNER RN, ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2009
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date: 04/22/2021
Reactivation Date: 05/13/2021

III. Provider practice location address

250 BLOSSOM ST FL 4
WEBSTER TX
77598-4204
US

IV. Provider business mailing address

301 UNIVERSITY BLVD
GALVESTON TX
77555-5302
US

V. Phone/Fax

Practice location:
  • Phone: 832-632-2041
  • Fax:
Mailing address:
  • Phone: 409-772-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP116676
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: