Vivia Paulette Kelley, LVN
Individual provider Active NPI Licensed Vocational Nurse · Willis, TX
NPI 1437637428 · NPPES record last updated Aug 1, 2018
Key facts
- NPI
- 1437637428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- 172973 (TX)
- Practice address
- 13662 Bighorn TRL
Willis, TX 77378-4058 - Phone
- (936) 524-7390
- NPI assigned
- Aug 1, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 172973 | TX | MD | Licensed Vocational Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 172973 | TX | Yes |
Addresses
Primary practice location
13662 Bighorn TRL
Willis, TX 77378-4058
Mailing address
211 Prince of Wales St
Conroe, TX 77304-2717
Phone (936) 524-7390
Other providers in Willis, TX
- Meredith Jurica
- Kalliope'S Ranch Corporation
- Chani Kantis
- Michael Scott Kearney
- Madison Dawn Keller
- Brian J Kempton
- Kingwood Physical Therapy LTD
- Kelly Kocian
- Kroger Texas L P
- Rhonda Louk Kuehn
All providers in Willis, TX · Licensed Vocational Nurse in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.