Individual
MRS. KELLY MACKENZIE THUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, PHN
Contact information
Practice address
1725 W 17TH ST, SANTA ANA, CA 92706-2316
(714) 834-8505
(714) 834-7977
Mailing address
3829 E 15TH ST, LONG BEACH, CA 90804
(714) 834-8505
(714) 834-7977
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
605070
CA
Other
Enumeration date
11/13/2007
Last updated
11/29/2007
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