Individual
CORTNEY KECKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
8831 VILLA LA JOLLA DR, LA JOLLA, CA 92037-1949
(858) 457-4480
Mailing address
1792 GARNET AVE, SAN DIEGO, CA 92109-3350
(858) 457-4480
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95013356
CA
Other
Enumeration date
12/14/2019
Last updated
11/09/2021
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