Provider Demographics
NPI:1932777901
Name:JAMES, KELLY MILOU (FNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:MILOU
Last Name:JAMES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 FRISCO SQUARE BLVD STE 530
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3303
Mailing Address - Country:US
Mailing Address - Phone:972-566-5255
Mailing Address - Fax:972-566-5236
Practice Address - Street 1:5575 FRISCO SQUARE BLVD STE 530
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3303
Practice Address - Country:US
Practice Address - Phone:972-566-5255
Practice Address - Fax:972-566-5255
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty