Provider Demographics
NPI:1215972807
Name:SCHERER, KELLY A (ANP)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:SCHERER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 VILLAGE PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-3301
Mailing Address - Country:US
Mailing Address - Phone:469-800-0500
Mailing Address - Fax:469-800-0510
Practice Address - Street 1:2900 VILLAGE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-3301
Practice Address - Country:US
Practice Address - Phone:469-800-0500
Practice Address - Fax:469-800-0510
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115034363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX191445905Medicaid
TX191445904Medicaid
TX191445906Medicaid
TX191445905Medicaid
TX191445906Medicaid
TX191445904Medicaid