Smith, Bonnie Kellam

Smith, Bonnie Kellam is an individual health care provider with primary practice located at 4600 Gulf Fwy , Houston TX 77023-3548. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Women's Health is her primary health care specialty. Smith, Bonnie Kellam can be contacted via phone (713) 522-3976.

Contact Information

Primary practice address
4600 Gulf Fwy Houston TX 77023-3548
Phone: (713) 522-3976
Fax: (404) 494-7435
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X AP103014 Texas
Nursing Service Providers / Registered Nurse 163W00000X RN452065 Texas
Nursing Service Providers / Registered Nurse 163W00000X RN112114 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X AP04701 Louisiana

Profile Details

NPI number 1053518894
LBN Legal business name Smith, Bonnie Kellam
Credentials WHCNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2007
Last updated Sep 13th, 2019 - about 7 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 1053518894 NPPES
Louisiana MEDICAID 1815365
Louisiana MEDICAID 0708125-03

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