Individual
MITCHELL GRAYSON KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
5323 HARRY HINES BLVD MAILCODE 8590, DALLAS, TX 75390-0001
(214) 645-2621
Mailing address
5323 HARRY HINES BLVD MAILCODE 8590, DALLAS, TX 75390-0001
(361) 232-7638
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP138687
TX
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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