Provider Demographics
NPI:1801491980
Name:KELBY, CHUNNER ELISHA (RN)
Entity type:Individual
Prefix:
First Name:CHUNNER
Middle Name:ELISHA
Last Name:KELBY
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 1:1426 GLENSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1735
Mailing Address - Country:US
Mailing Address - Phone:469-274-3524
Mailing Address - Fax:
Practice Address - Street 1:1426 GLENSHIRE DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1735
Practice Address - Country:US
Practice Address - Phone:469-274-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX879169163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology