Individual
KELLI SAMPLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5770 RIVERSIDE DR., BLDG 601, 752 MEDICAL SQUADRON, MARCH ARB, CA 92518
(951) 655-5167
Mailing address
6323 ECHO HILLS LN, FONTANA, CA 92336-5837
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
95090882
CA
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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