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General NPI Number Information
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NPI Number | 1063643922
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Entity Type | Individual
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Provider Name | KELLEY KENNEDY SCHULZE PNP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 11/16/2016
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Provider Practice Location Address
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Address Line | 1651 ROCK PRAIRIE RD #102
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City | COLLEGE STATION
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State | TX
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Zip | 77845-8652
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Country | US
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Telephone | 979-693-7400
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Fax | 979-693-7446
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Provider Business Mailing Address
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Address Line | 1500 UNIVERSITY DR E #100
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City | COLLEGE STATION
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State | TX
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Zip | 77840-2600
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Country | US
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Telephone | 979-846-1100
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Fax | 979-260-9390
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 650862
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License Number State | TX
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