Individual
TRICIA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1325 PENNSYLVANIA AVENUE SUITE 560, FORT WORTH, TX 76104
(817) 820-2890
(817) 810-0725
Mailing address
1216 BERKELEY DR, BURLESON, TX 76028-8220
(817) 905-6050
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
821766
TX
Other
Enumeration date
04/11/2018
Last updated
06/13/2023
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