Provider Demographics
NPI:1588042162
Name:VU, KELLEY TRAN (NP-C)
Entity type:Individual
Prefix:MS
First Name:KELLEY
Middle Name:TRAN
Last Name:VU
Suffix:
Gender:F
Credentials:NP-C
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:901 W 38TH ST STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1166
Practice Address - Country:US
Practice Address - Phone:512-421-4100
Practice Address - Fax:512-419-0924
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP127780363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX361837302Medicaid