Provider Demographics
NPI:1619423506
Name:KELANI, JADESOLA (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JADESOLA
Middle Name:
Last Name:KELANI
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20403 KIWI PL
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-2068
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1850 W LAKE HOUSTON PKWY
Practice Address - Street 2:#150
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-5237
Practice Address - Country:US
Practice Address - Phone:281-318-7386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131849363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily