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Individual
KELLY J EISAMAN
Active
Individual
KELLY J EISAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NPC
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP114213
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N9199
BLUE CROSS PROV NUMBER
TX
Enumeration date
12/05/2005
Last updated
10/21/2025
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