Provider Demographics
NPI:1568838936
Name:GIRON, KELLI ELIZABETH (DNP, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:ELIZABETH
Last Name:GIRON
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 RENTFROW AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5145
Mailing Address - Country:US
Mailing Address - Phone:575-621-2862
Mailing Address - Fax:
Practice Address - Street 1:105 W GRIGGS AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1235
Practice Address - Country:US
Practice Address - Phone:575-647-2879
Practice Address - Fax:575-647-2898
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-77692163W00000X
NM57899363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse