Rayburn, Kelly Anne
Rayburn, Kelly Anne is an individual health care provider with primary practice located at 1100 Wilford Hall Loop , Jbsa Lackland TX 78236-5638. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Rayburn, Kelly Anne can be contacted via phone (210) 314-0779.Contact Information
Primary practice address
1100 Wilford Hall Loop
Jbsa Lackland TX 78236-5638
Phone: (210) 314-0779
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA05332 | Texas |
Profile Details
| NPI number | 1548228398 |
|---|---|
| LBN Legal business name | Rayburn, Kelly Anne |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2006 |
| Last updated | Dec 2nd, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548228398 | NPPES |
| Texas | MEDICAID | 345120501 | |
| Texas | Other | P01008379 |
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