Individual
KELLI NICOLE LEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13900 MARQUESAS WAY APT 5417, MARINA DEL REY, CA 90292-6076
(424) 208-4630
Mailing address
2989 MARBLE STONE AVE, HENDERSON, NV 89044-1689
(424) 208-4630
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
53766
CA
363AM0700X
Medical Physician Assistant
Primary
PA2010
NV
Other
Enumeration date
05/15/2016
Last updated
02/22/2019
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