Individual
KELLY VIRS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
689 JAZMIN AVE, VENTURA, CA 93004-1827
(805) 258-6286
Mailing address
689 JAZMIN AVE, VENTURA, CA 93004-1827
(805) 258-6286
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
848002
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95025197
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163W00000X
REGISTERED NURSE
CA
Enumeration date
08/13/2013
Last updated
01/15/2024
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