Individual
DENISE I. KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
13737 NOEL ROAD, STE 1400, DALLAS, TX 75240-2004
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
662934
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167815301
—
TX
05
—
167815303
—
TX
05
—
167815304
—
TX
01
—
85926U
BCBS
TX
01
—
P01002880
RAILROAD
TX
Enumeration date
07/14/2005
Last updated
05/21/2014
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