Individual
KELLY L NEWSOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
105 MEDICAL PLZ, SULPHUR SPRINGS, TX 75482-2136
(903) 885-5439
Mailing address
PO BOX 1367, SULPHUR SPRINGS, TX 75483-1367
(903) 438-3336
(903) 438-3385
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
688654
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206333102
—
TX
Enumeration date
09/13/2007
Last updated
08/06/2015
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