Individual
KELSEY LAUREN ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, WHNP-BC
Contact information
Practice address
1417 2ND ST STE D, SANTA MONICA, CA 90401-2399
(646) 650-5337
(646) 871-6820
Mailing address
1417 2ND ST STE D, SANTA MONICA, CA 90401-2399
(918) 857-8740
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0133249
OK
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
0024180210
VA
367A00000X
Advanced Practice Midwife
—
—
Other
Enumeration date
09/14/2020
Last updated
03/15/2024
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