MITCHELL GRAYSON KELLY (NPI# 1134696453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134696453 |
Entity Type | Individual |
Full Name | MITCHELL GRAYSON KELLY |
Credential | AGACNP |
Practice Address |
5323 Harry Hines Blvd Mailcode 8590 Dallas TX 75390-0001 |
Practice Telephone | 2146452621 |
Mailing Telephone | 3612327638 |
Enumeration Date | 2018-10-24 |
Last Update Date | 2018-10-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
AP138687 | TX | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
5323 HARRY HINES BLVD MAILCODE 8590 |
City | DALLAS |
State | TX |
Zip Code | 75390-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467075655 | Richard Mark Bresler | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Mc9159, Dallas, TX 75390 | 2020-05-21 |
1356970735 | Fabricio Stewan Feltrin | Student in an Organized Health Care Education/Training Program | 5323 Harry Hynes Boulevard, Dallas, TX 75390 | 2020-04-07 |
1477016467 | Seagal Raza Dauglas | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Mc9159, Dallas, TX 75390 | 2019-04-08 |
1831674340 | Adwoa Aninkorah | Nurse Practitioner | Ut Southwestern Medical Center 5151 Harry Hines Blvd, Dallas, TX 75390 | 2018-10-01 |
1194212712 | Christian Lobue | Clinical Neuropsychologist | 6333 Forest Park Road, 1st Floor, Bla 100, Dallas, TX 75390 | 2018-04-19 |
1912439720 | Linsey Lindley | Student in an Organized Health Care Education/Training Program | 5939 Harry Hines Blvd 4th Floor Suite 100, Dallas, TX 75390 | 2017-03-30 |
1043759418 | Alyssa Macchiaroli | Registered Nurse | 5323 Harry Hines Blvd Mail Code 8590, Dallas, TX 75390 | 2017-02-18 |
1609313980 | Megan Rasmussen Bollner | Physician Assistant | 5303 Harry Hines Blvd Fl 9, Dallas, TX 75390 | 2017-01-25 |
1518329168 | Danny Hsu Yang | Hospitalist | 6201 Harry Hines Blved, Dallas, TX 75390 | 2016-03-23 |
1780046532 | Omer Mirza | Hospitalist | 6201 Harry Hines Blvd Dallas, Dallas, TX 75390 | 2016-03-22 |
Find all providers in zip 75390 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669083077 | Renee Mieselle Lies | Nurse Practitioner | 2602 Mckinney Ave Ste 115, Dallas, TX 75204-0727 | 2020-08-11 |
1518592534 | Raven Aravind | Nurse Practitioner | 1900 Caddo Street, Number 4, Dallas, TX 75204-4223 | 2020-03-10 |
1366090417 | Maria Whitney Nance | Nurse Practitioner | 7777 Forest Ln Ste D308, Dallas, TX 75230-2571 | 2019-09-02 |
1336708361 | Sunny Dedmon | Nurse Practitioner | 3225 Turtle Creek Blvd Apt 520, Dallas, TX 75219-5461 | 2019-06-12 |
1306401419 | Quatina Lasha Rivers-fleming | Nurse Practitioner | 522 Ivy Chase Loop, Dallas, GA 30157-0946 | 2019-05-03 |
1679136220 | Marvise Ijeoma Oduagu | Nurse Practitioner | 305 W Commerce St Apt 336, Dallas, TX 75208-1985 | 2019-04-19 |
1851860365 | Yoon Jung Ra | Nurse Practitioner | 2610 Allen St Apt 5410, Dallas, TX 75204-2447 | 2018-11-14 |
1710411822 | Latosca Brunner | Nurse Practitioner | 221 W Beckley Blvd, Pavilion 2 Suite 929, Dallas, TX 75202 | 2017-04-14 |
1376900746 | Lashandra Gray | Nurse Practitioner | 9111 Prairie Bluff Dr, Dallas, TX 75227-5245 | 2016-01-15 |
1952773251 | Dorothy Ntende | Nurse Practitioner | 11816 Inwood Rd, Pmb 147, Dallas, TX 75244-8011 | 2015-10-26 |
Find all providers in DALLAS |
Please comment or provide details below to improve the information on MITCHELL GRAYSON KELLY.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.