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General NPI Number Information
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NPI Number | 1902554306
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Entity Type | Individual
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Provider Name | KELLY L NEPHEW DNP, FNP-BC, CME
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Gender | Female
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 444 N WEST VIEW DR
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City | OSCEOLA
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State | IA
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Zip | 50213-8267
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Country | US
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Telephone | 337-991-9276
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3373
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City | ROCK ISLAND
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State | IL
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Zip | 61204-3373
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Country | US
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Telephone | 563-219-7225
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Fax | 563-823-6665
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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 | A167920
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 277.003818
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License Number State | IL
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