Kelly Kullenberg, LVN
Licensed Vocational Nurse in Austin, TX. Individual provider (NPI-1).
NPI number1982186433
StatusActive
Last updated in NPPESAug 31, 2018
Details
- NPI
- 1982186433
- Entity type
- Individual (NPI-1)
- Name
- Kelly Kullenberg
- Credential
- LVN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 31, 2018
- Last updated
- Aug 31, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164X00000X | Licensed Vocational Nurse | 149133 | TX | Yes |
Practice location
3508 Far West BlvdAustin, TX 78731-3080
Phone 512-828-3990
Mailing address
1812 Paseo Verde DrLeander, TX 78641-8293
Phone 512-426-3515
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