Provider Demographics
NPI:1740021872
Name:NANJI, KATHRYN-KELLER
Entity type:Individual
Prefix:
First Name:KATHRYN-KELLER
Middle Name:
Last Name:NANJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 E OAKENWALD ST APT 536
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-0913
Mailing Address - Country:US
Mailing Address - Phone:240-507-6040
Mailing Address - Fax:
Practice Address - Street 1:390 E OAKENWALD ST APT 536
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-0913
Practice Address - Country:US
Practice Address - Phone:240-507-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078332163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical