Individual
VIVIENNE M. KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3355 RIVERBEND DR STE 240, SPRINGFIELD, OR 97477-8800
(541) 683-5001
(541) 683-1422
Mailing address
300 S DIAMOND AVE, DEMING, NM 88030-3752
(575) 546-4336
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10026337
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500845664
—
OR
Enumeration date
04/09/2019
Last updated
08/29/2025
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