Provider Demographics
NPI:1053897298
Name:NWULI, KELLI (NP)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:NWULI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N SHEPHERD DR STE 124
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-4717
Mailing Address - Country:US
Mailing Address - Phone:832-564-0344
Mailing Address - Fax:
Practice Address - Street 1:600 N SHEPHERD DR STE 124
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-4717
Practice Address - Country:US
Practice Address - Phone:832-564-0344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily