Provider Demographics
NPI:1083371728
Name:EIFLING, KELLY M (AG-ACNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:M
Last Name:EIFLING
Suffix:
Gender:F
Credentials:AG-ACNP
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4375 BOOTH CALLOWAY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8365
Mailing Address - Country:US
Mailing Address - Phone:817-284-3915
Mailing Address - Fax:844-289-7694
Practice Address - Street 1:4375 BOOTH CALLOWAY RD STE 400
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8365
Practice Address - Country:US
Practice Address - Phone:817-284-3915
Practice Address - Fax:844-289-7694
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX849895363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care