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Individual

MRS. KELLY MICHELE CERUTTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
925 CALIFORNIA AVENUE, CVS MINUTECLINIC #09300, WAHIAWA, HI 96786
(808) 621-7772
Mailing address
CVS MINUTECLINIC #09300, 925 CALIFORNIA AVENUE, WAHIAWA, GA 96786
(808) 621-7772

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
104121
AK
363LF0000X
Family Nurse Practitioner
22569
AK
363LF0000X
Family Nurse Practitioner
Primary
2300
HI

Other

Enumeration date
08/21/2015
Last updated
03/17/2018
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