Provider Demographics
NPI:1912045881
Name:VIERS, KELLI (RN)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:VIERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 PLEASURE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HAYSI
Mailing Address - State:VA
Mailing Address - Zip Code:24256
Mailing Address - Country:US
Mailing Address - Phone:276-835-9449
Mailing Address - Fax:
Practice Address - Street 1:133 MCCLURE AVE
Practice Address - Street 2:
Practice Address - City:CLINTWOOD
Practice Address - State:VA
Practice Address - Zip Code:24228-0309
Practice Address - Country:US
Practice Address - Phone:276-926-1680
Practice Address - Fax:276-926-9179
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0001122581OtherBOARD OF NURSING