Individual
KELLY VANDER VEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2930 2ND AVE STE 120, MARINA, CA 93933-6244
(831) 622-6935
Mailing address
165 PETERY LN, APTOS, CA 95003-9703
(831) 818-6886
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95032694
CA
Other
Enumeration date
08/17/2023
Last updated
01/07/2025
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