Provider Demographics
NPI:1811744055
Name:KELLEY, DARLENE RENEE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:RENEE
Last Name:KELLEY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:11011 RICHMOND AVE STE 711
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-6720
Mailing Address - Country:US
Mailing Address - Phone:346-536-8378
Mailing Address - Fax:713-583-5434
Practice Address - Street 1:11011 RICHMOND AVE STE 711
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-6720
Practice Address - Country:US
Practice Address - Phone:346-536-8378
Practice Address - Fax:713-583-5434
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX584973163WA0400X, 163WC1500X, 163WP0808X, 171400000X, 246RP1900X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No171400000XOther Service ProvidersHealth & Wellness Coach
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy