=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508761594
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DELTA TOXICOLOGY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2026
-----------------------------------------------------
Last Update Date | 10/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 503 E TELEGRAPH ST
-----------------------------------------------------
City | CARSON CITY
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89701-4215
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-200-5256
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1607
-----------------------------------------------------
City | CRYSTAL BAY
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89402-1607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-200-5256
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. KATHRYN E KELLY
-----------------------------------------------------
Credential | DRPH
-----------------------------------------------------
Telephone | 775-200-5256
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2083T0002X
-----------------------------------------------------
Taxonomy Name | Medical Toxicology (Preventive Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------