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Individual

KELLY ELIZABETH KOTULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, CPNP

Contact information

Practice address
3665 KEARNY VILLA RD STE 400, SAN DIEGO, CA 92123-1955
(858) 966-8801
Mailing address
3665 KEARNY VILLA RD STE 400, SAN DIEGO, CA 92123-1955
(858) 966-8801

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
NP95012078
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
NP95012078
CA

Other

Enumeration date
07/11/2019
Last updated
06/29/2020
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