Mrs Matilda Denise Kelley, BSN, RN, CLT is a
Registered Nurse based in Vidor, Texas. Mrs Matilda Denise Kelley is licensed to practice in Texas (license number 769373) and her current practice location is
2750 Highway 12, Vidor, Texas. She can be reached at her office (for appointments etc.) via phone at
(409) 659-7306.
NPI number for Mrs Matilda Denise Kelley is 1194503391 and her current mailing address is 2699 Marion St, Vidor, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1194503391.
Provider's Profile
| Full Name | Mrs Matilda Denise Kelley |
|---|
| Gender | Female |
|---|
| Speciality | Registered Nurse |
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| Location | 2750 Highway 12, Vidor, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1194503391
- Provider Enumeration Date: 09/19/2023
- Last Update Date: 09/24/2024
Medical Identifiers
Medical identifiers for Mrs Matilda Denise Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1194503391 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 769373 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Matilda Denise Kelley is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Matilda Denise Kelley, BSN, RN, CLT
2699 Marion St,
Vidor, TX 77662-8192
Ph: (409) 201-5293 | Mrs Matilda Denise Kelley, BSN, RN, CLT
2750 Highway 12,
Vidor, TX 77662-3435
Ph: (409) 659-7306 |
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