Provider Demographics
NPI:1851577902
Name:HARPER, KELLY DIANE (PNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:DIANE
Last Name:HARPER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
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Mailing Address - Street 1:3150 CLARKSVILLE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-8076
Mailing Address - Country:US
Mailing Address - Phone:903-782-9206
Mailing Address - Fax:903-783-7367
Practice Address - Street 1:3150 CLARKSVILLE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-8076
Practice Address - Country:US
Practice Address - Phone:903-782-9206
Practice Address - Fax:903-783-7367
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2008-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX573273363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics