Christine Kellam, R.N11

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

517241 Issued in TX

Practice address

3330 S Lancaster Rd
Dallas, TX 75216-4531

Phone

(214) 371-6639

Fax

(214) 372-6199

NPI assigned

Jul 8, 2010

Last updated

Jul 8, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1568774420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5731 LAZY RIVER DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752412206",
            "telephone_number": "214-376-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752164531",
            "telephone_number": "214-371-6639",
            "fax_number": "214-372-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAM",
        "first_name": "CHRISTINE",
        "credential": "R.N11",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "517241",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "TX",
            "license": "517241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keleac Ventures LLC (Accelerated Wellness)
• Bereket Kelela
• Theodoros Kelesidis, MD
• Keli S. Jones M.D., PA
• Jenny Kell, OTR
• Madeline Sparks Kellam, MD
• Stella Caroline Kellams
• Keller Psychology
• Camryn Lisa Keller
• Darla Keller

• Adult Psychiatric/Mental Health Registered Nurse in Dallas, TX
• Providers in Dallas, TX by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.