Provider Demographics
NPI:1194532820
Name:KELLEY, VICTORIA P (NP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:P
Last Name:KELLEY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:HOPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:11722 MARSH LN STE 372
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-2682
Mailing Address - Country:US
Mailing Address - Phone:214-366-0061
Mailing Address - Fax:214-366-0062
Practice Address - Street 1:11722 MARSH LN STE 372
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-2682
Practice Address - Country:US
Practice Address - Phone:214-366-0061
Practice Address - Fax:214-366-0062
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF12240351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily