Provider Demographics
NPI:1689045957
Name:REEKIE, KELSEY ELIZABETH (AGACNP)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:ELIZABETH
Last Name:REEKIE
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Gender:F
Credentials:AGACNP
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Mailing Address - Street 1:3315 COLORADO BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6885
Mailing Address - Country:US
Mailing Address - Phone:940-320-1708
Mailing Address - Fax:940-565-5457
Practice Address - Street 1:4240 INTERNATIONAL PKWY
Practice Address - Street 2:SUITE 154
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1970
Practice Address - Country:US
Practice Address - Phone:469-574-0464
Practice Address - Fax:469-574-0471
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2020-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP129339363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX354727501Medicaid
TX354727501Medicaid