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Individual

KELLY LYNN SAMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1737 BRIARCREST DR, SUITE 14, BRYAN, TX 77802-2769
(979) 776-4777
(979) 776-0588
Mailing address
1737 BRIARCREST DR, SUITE 14, BRYAN, TX 77802-2769
(979) 776-4777
(979) 776-0588

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP131705
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
361898501
TX
Enumeration date
06/20/2016
Last updated
08/14/2024
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