Kelley Deming Mathis, RN

Individual provider Active NPI Emergency Registered Nurse · Andrews, TX

NPI 1437969748 · NPPES record last updated Jan 9, 2025

Key facts

NPI
1437969748
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Registered Nurse 163WE0003X
License
804014 (TX)
Practice address
720 Hospital Dr
Andrews, TX 79714-3617
Phone
(432) 464-2200
Fax
(432) 464-2177
NPI assigned
Jan 9, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
804014TXMDMedical-Surgical Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 804014 TX
Emergency Registered Nurse 163WE0003X 804014 TX Yes

Addresses

Primary practice location

720 Hospital Dr
Andrews, TX 79714-3617

Mailing address

720 Hospital Dr
Andrews, TX 79714-3617
Phone (432) 464-2200

Other names

  • Kelley Marie Deming Former name

Other providers in Andrews, TX

All providers in Andrews, TX · Emergency Registered Nurse in Texas

Sources for this page

Verify at the official NPI Registry.