Provider Demographics
NPI:1609324870
Name:PRITCHARD, KELLI (FNP-C)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 OAK ST STE 102
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-1527
Mailing Address - Country:US
Mailing Address - Phone:325-670-9552
Mailing Address - Fax:
Practice Address - Street 1:400 OAK ST STE 102
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-1527
Practice Address - Country:US
Practice Address - Phone:325-670-9552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131985363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily