KELLY KAY WENGER (NPI# 1518292077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518292077 |
| Entity Type | Individual |
| Full Name | KELLY KAY WENGER |
| Other Name | KELLY BURROWS WENGER |
| Credential | FNP |
| Practice Address |
408 N Hancock Ave Odessa TX 79761-5140 |
| Practice Telephone | 4325807373 |
| Practice Fax Number | 4325803275 |
| Mailing Telephone | 4325807373 |
| Mailing Fax Number | 4325803275 |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2019-08-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
709977 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 520 E 6th St, Odessa, TX 797614527 | 4325828000 | 6158463006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114442811 | Kelly Wenger | Physical Therapist | 1076 W Chandler Blvd Ste 103, Chandler, AZ 85224-5223 | 2017-08-03 |
| Street Address |
408 N HANCOCK AVE |
| City | ODESSA |
| State | TX |
| Zip Code | 79761-5140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417953589 | Robert Kevin Lynch | Surgery | 408 N Hancock Ave, Odessa, TX 79761-5140 | 2005-06-23 |
| 1528435153 | Cody Mygrant | Physician Assistant | 408 N Hancock Ave, Odessa, TX 79761-5140 | 2015-08-31 |
| 1417363268 | Michael Janice | Surgery | 408 N Hancock Ave, Odessa, TX 79761-5140 | 2014-07-01 |
| 1023136116 | Triton Surgical Associates Pa | Surgery | 408 N Hancock Ave, Odessa, TX 79761-5140 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482003 | Endovascular Lab Pllc | Surgery | 612 N Washington Avenue, Suite 100, Odessa, TX 79761 | 2020-03-16 |
| 1235627605 | Megan Elizabeth Lemond | Pediatrics | 912 E 5th St, Odessa, TX 79761 | 2018-05-01 |
| 1922522630 | Brian W Griffin | Nurse Practitioner | 4606 Fountain Ln., Odessa, TX 79761 | 2017-08-03 |
| 1023540507 | Florenda De Guzman | Nurse Practitioner | 405 N Tom Green, Odessa, TX 79761 | 2017-04-03 |
| 1205378239 | Scotty R Ortega Md | Clinical Nurse Specialist | 2487 E 11th Street, Odessa, TX 79761 | 2016-11-08 |
| 1487094355 | Marivel Perez | Nurse Practitioner | 540 W 5th St Ste 350, Ste. 350, Odessa, TX 79761 | 2013-06-25 |
| 1245579804 | Accurate Health Care LLC | Home Health | 302 Industrial Ave, Odessa, TX 79761 | 2013-02-01 |
| 1437421666 | Mary Magdalene Garcia | Speech-Language Pathologist | 620 N. Alleghaney, Odessa, TX 79761 | 2012-02-03 |
| 1841576378 | Ashley Burdex | Family Medicine | 6030 W University, Odessa, TX 79761 | 2011-10-28 |
| 1730465428 | Therese A Archer | Massage Therapist | 712 N. Texas Ave, Odessa, TX 79761 | 2011-10-26 |
| Find all providers in zip 79761 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639776115 | Taylor Marie Russell | Nurse Practitioner | 15217 Wind Whisper Dr, Odessa, FL 33556-1832 | 2020-10-07 |
| 1992310551 | Taylor Barnes | Nurse Practitioner | 5919 Fitzgerald Rd, Odessa, FL 33556-2355 | 2020-09-10 |
| 1558995753 | Mission Health, Pllc | Nurse Practitioner | 3112 San Saba Dr, Odessa, TX 79765-5058 | 2020-02-26 |
| 1710549084 | Alyce Greenwood | Nurse Practitioner | 16501 Harper Pond Ln Apt 301, Odessa, FL 33556-6101 | 2019-07-08 |
| 1073170411 | Trudian Alicia Lester | Nurse Practitioner | 8050 E Highway 191 Ste 104, Odessa, TX 79765-8614 | 2019-05-21 |
| 1043773153 | Janette Garcia | Nurse Practitioner | 420 E 6th St Ste 201b, Odessa, TX 79761-4572 | 2019-04-08 |
| 1073074258 | Courtney Clubb | Nurse Practitioner | 410 N Hancock Ave # 4, Odessa, TX 79761-5140 | 2019-03-28 |
| 1891256434 | Joann Mercedes Georges Guillory | Nurse Practitioner | 56 Berkshire Cir, Odessa, TX 79765-2218 | 2019-03-27 |
| 1689138521 | Jacqueline Alcantara | Nurse Practitioner | 15103 Virginia Sta Apt 214, Odessa, FL 33556-3579 | 2019-01-24 |
| 1841767597 | Michael Ebrada | Nurse Practitioner | 16400 Rollingbrook Dr, Odessa, FL 33556-4907 | 2018-10-31 |
| Find all providers in ODESSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.