Individual
KERTARA ELLERBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5560 ACKERFIELD AVE, LONG BEACH, CA 90805-4958
(562) 477-6599
Mailing address
5560 ACKERFIELD AVE, LONG BEACH, CA 90805-4958
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
714456
CA
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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