Individual
KELLEY CERASUOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
5600 S WILLOW DR STE 117, HOUSTON, TX 77035-4721
(713) 723-5600
(713) 772-5602
Mailing address
12377 MERIT DR STE 300, DALLAS, TX 75251-3126
(972) 957-3000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP111450
TX
363LP0200X
Pediatric Nurse Practitioner
AP111450
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147339901
—
TX
Enumeration date
10/17/2006
Last updated
10/29/2025
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