Provider Demographics
NPI:1750825022
Name:PLYLER, KELLY BRENNA (ARNP, AGACNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:BRENNA
Last Name:PLYLER
Suffix:
Gender:F
Credentials:ARNP, AGACNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:BRENNA
Other - Last Name:SEITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP
Mailing Address - Street 1:1600 F ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3012
Mailing Address - Country:US
Mailing Address - Phone:360-733-3710
Mailing Address - Fax:360-733-7906
Practice Address - Street 1:1600 F ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3012
Practice Address - Country:US
Practice Address - Phone:360-733-3710
Practice Address - Fax:360-733-7906
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2022-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.433856163W00000X
WAAP61103096363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse