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Individual

KELLI HUMPHREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1071 SKYLINE DR, LAGUNA BEACH, CA 92651-1934
(949) 233-5943
(949) 715-1087
Mailing address
PO BOX 449, LAGUNA BEACH, CA 92652-0449
(949) 233-5943
(949) 715-1087

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11464
CA

Other

Enumeration date
07/21/2006
Last updated
04/02/2010
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