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General NPI Number Information
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NPI Number | 1417496910
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Entity Type | Individual
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Provider Name | KELLY MICHELE WHITSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/16/2017
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 506 E SAN ANTONIO ST
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City | VICTORIA
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State | TX
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Zip | 77901-6060
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Country | US
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Telephone | 361-575-7441
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Fax |
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Provider Business Mailing Address
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Address Line | 117 ZEPHYR DR
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City | VICTORIA
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State | TX
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Zip | 77904-3446
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Country | US
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Telephone | 361-920-1918
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP133246
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License Number State | TX
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