Individual
DIANA L KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1636 HUNTERS GLEN RD, SAN ANGELO, TX 76901-5008
(325) 949-5722
Mailing address
1636 HUNTERS GLEN RD, SAN ANGELO, TX 76901-5016
(325) 949-5722
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1033066
TX
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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