Provider Demographics
NPI:1831706530
Name:NEWTON, KELSEY NICOLE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:NICOLE
Last Name:NEWTON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 W MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:VAN
Mailing Address - State:TX
Mailing Address - Zip Code:75790-2608
Mailing Address - Country:US
Mailing Address - Phone:903-570-1129
Mailing Address - Fax:
Practice Address - Street 1:488 W MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:VAN
Practice Address - State:TX
Practice Address - Zip Code:75790-2608
Practice Address - Country:US
Practice Address - Phone:903-963-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-26
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX953026163WP2201X
TX1094943363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care