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Individual
KELLY RENEE PACHECO
Active
Individual
KELLY RENEE PACHECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
805693
TX
363LF0000X
Family Nurse Practitioner
Primary
255690
AZ
363LF0000X
Family Nurse Practitioner
903937
MS
363LF0000X
Family Nurse Practitioner
AP144798
TX
Other
Enumeration date
04/10/2017
Last updated
10/06/2022
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