Kelly Bacon, Dalisa

Kelly Bacon, Dalisa is an individual health care provider with primary practice located at 7710 West I 10 , San Antonio TX 78230. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Nurse's Aide, Nursing Service Providers / Licensed Vocational Nurse. Nursing Service Providers / Licensed Vocational Nurse is her primary health care specialty. Kelly Bacon, Dalisa can be contacted via phone (210) 377-3355.

Contact Information

Primary practice address
7710 West I 10 San Antonio TX 78230
Phone: (210) 377-3355
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Nurse's Aide 376K00000X
Nursing Service Providers / Licensed Vocational Nurse 164X00000X 1014667 Texas

Profile Details

NPI number 1063062800
LBN Legal business name Kelly Bacon, Dalisa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2019
Last updated Nov 17th, 2020 - about 5 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 1063062800 NPPES
Texas Other 081598 HEALTH SHEILD

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