KENDRA L MCNELLYE-MATTOX RN DFNP-BC NPI 1295712776

NPI Information

NPI: 1295712776
Provider Name: KENDRA L MCNELLYE-MATTOX, RN, DFNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
8061 ALAMEDA AVE
EL PASO, TX
ZIP 79915
Phone: (915) 351-8972
Get Directions

Kendra L Mcnellye-mattox, RN, DFNP-BC is a family nurse practitioner in El Paso, TX. Kendra L Mcnellye-mattox, RN, DFNP-BC NPI is 1295712776. 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:

8061 ALAMEDA AVE
EL PASO, TX
ZIP 79915-705
Phone: (915) 351-8972
Fax: (915) 351-6033

The enumeration date for this NPI number is 12/27/2005 and was last updated on 7/24/2015.

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	363LF0000X	Nurse Practitioner	Family	AP124124	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	F1104136	OTHER		AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION #
2	Q24550	MEDICARE UPIN
3	200491110	MEDICAID	INDIANA
4	113810RR	MEDICARE PIN	INDIANA
5	000000487073	OTHER	INDIANA	BLUE SHIELD
6	P00301672	OTHER	INDIANA	RR MEDICARE
7	83625739	MEDICAID	NEW MEXICO

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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