KELLEY D ELLIS RNFA CNOR NPI 1073622858

NPI Information

NPI: 1073622858
Provider Name: KELLEY D ELLIS, RNFA, CNOR
Classification: Registered Nurse - 163WM0705X
Entity Type: Individual

Specialization: Medical-Surgical

Address:
1900 MISTLETOE BLVD STE 200
FORT WORTH, TX
ZIP 76104
Phone: (817) 878-5333
Get Directions

Kelley D Ellis, RNFA, CNOR is a medical-surgical registered nurse in Fort Worth, TX. Kelley D Ellis, RNFA, CNOR NPI is 1073622858. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1900 MISTLETOE BLVD STE 200
FORT WORTH, TX
ZIP 76104-049
Phone: (817) 878-5333
Fax: (817) 878-5334

The enumeration date for this NPI number is 8/29/2006 and was last updated on 2/4/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WM0705X	Registered Nurse	Medical-Surgical	551667	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0672032	OTHER	TEXAS	CIGNA
2	89N921	OTHER	TEXAS	BCBS OF TX
3	7521427	OTHER	TEXAS	AETNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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