Provider Demographics
NPI:1518292077
Name:BURROWS, KELLY KAY (FNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:KAY
Last Name:BURROWS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:KAY
Other - Last Name:BURROWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:5031 WAYLAND DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5534
Mailing Address - Country:US
Mailing Address - Phone:432-580-7320
Mailing Address - Fax:432-580-7318
Practice Address - Street 1:5031 WAYLAND DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5534
Practice Address - Country:US
Practice Address - Phone:432-580-7320
Practice Address - Fax:432-580-7318
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX709977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily