Mcnellye-Mattox, Kendra L

Mcnellye-Mattox, Kendra L is an individual health care provider with primary practice located at 8061 Alameda Ave , El Paso TX 79915-4705. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mcnellye-Mattox, Kendra L can be contacted via phone (915) 351-8972.

Contact Information

Primary practice address
8061 Alameda Ave El Paso TX 79915-4705
Phone: (915) 351-8972
Fax: (915) 351-6033
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP124124 Texas

Profile Details

NPI number 1295712776
LBN Legal business name Mcnellye-Mattox, Kendra L
Credentials RN, DFNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated Jul 24th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295712776 NPPES
Indiana Other 000000487073 BLUE SHIELD
Indiana Other P00301672 BLUE SHIELD
Indiana MEDICAID 83625739 BLUE SHIELD
Indiana Other F1104136 BLUE SHIELD
Indiana MEDICAID 200491110 BLUE SHIELD

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