Provider Demographics
NPI:1326587353
Name:NEELY-GILBERT, KRISTEN RENEE (RN, MSN, CEN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:RENEE
Last Name:NEELY-GILBERT
Suffix:
Gender:F
Credentials:RN, MSN, CEN, FNP-C
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:R
Other - Last Name:NEELY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, MSN, CEN, FNP-C
Mailing Address - Street 1:618 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WOLFFORTH
Mailing Address - State:TX
Mailing Address - Zip Code:79382-3376
Mailing Address - Country:US
Mailing Address - Phone:806-789-6021
Mailing Address - Fax:
Practice Address - Street 1:708 S 1ST ST
Practice Address - Street 2:
Practice Address - City:MULESHOE
Practice Address - State:TX
Practice Address - Zip Code:79347-3627
Practice Address - Country:US
Practice Address - Phone:806-272-4524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133321363LF0000X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily