Kelly Shouse, FNP-C
Nurse Practitioner, Family in Modesto, CA. Individual provider (NPI-1).
NPI number1619706041
StatusActive
Last updated in NPPESAug 28, 2026
Details
- NPI
- 1619706041
- Entity type
- Individual (NPI-1)
- Name
- Kelly Shouse
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 1, 2024
- Certification date
- Aug 28, 2026
- Last updated
- Aug 28, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 95030512 | CA | Yes |
Practice location
1224 Scenic DrModesto, CA 95350-6137
Phone 209-442-6077 · Fax 833-573-2336
Mailing address
1224 Scenic DrModesto, CA 95350-6137
Phone 209-442-6077 · Fax 833-573-2336
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