Individual
LISA ANNE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2811 WILSHIRE BLVD STE 610, SANTA MONICA, CA 90403-4814
(310) 453-2335
Mailing address
2005 PERRY AVE, REDONDO BEACH, CA 90278-1824
(310) 415-4148
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95033922
CA
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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