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General NPI Number Information
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NPI Number | 1689931180
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Entity Type | Individual
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Provider Name | SUZANNE M KELLEY APRN, FNP-C, WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/20/2012
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 112 MAVERICK CT
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City | GRANBURY
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State | TX
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Zip | 76049-1381
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Country | US
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Telephone | 888-731-8994
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 THORNBERRY DR
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City | MCKINNEY
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State | TX
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Zip | 75071-5906
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Country | US
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Telephone |
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Fax | 318-401-2269
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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 | AP121560
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP121560
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License Number State | TX
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