Individual
KELLY S NIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
1000 FM 300, LEVELLAND, TX 79336-6235
(806) 894-7842
(806) 894-3378
Mailing address
1000 FM 300, LEVELLAND, TX 79336-6235
(806) 894-7842
(806) 894-3378
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4498
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121513902
—
TX
Enumeration date
05/12/2011
Last updated
05/12/2011
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