Individual
KELLY C KILCREASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
908 LAKESIDE LN, KERENS, TX 75144-6048
(318) 518-7967
Mailing address
908 LAKESIDE LN, KERENS, TX 75144-6048
(318) 518-7967
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP131121
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP131121
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265951453
GROUP NPI
TX
Enumeration date
07/12/2016
Last updated
04/30/2025
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