Provider Demographics
NPI:1184976441
Name:NESTEL, KELLY (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:NESTEL
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:DUVALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:MEDICAL CENTER BLVD
Mailing Address - Street 2:ANESTHESIOLOGY
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-1009
Mailing Address - Country:US
Mailing Address - Phone:336-716-3245
Mailing Address - Fax:336-713-4158
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-1009
Practice Address - Country:US
Practice Address - Phone:336-716-3245
Practice Address - Fax:336-713-4158
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005865363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily