Individual
KELLY CHRISTINE CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
365 S RANCHO SANTA FE RD STE 104, SAN MARCOS, CA 92078-2338
(866) 206-5644
Mailing address
365 S RANCHO SANTA FE RD STE 104, SAN MARCOS, CA 92078-2338
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95025291
CA
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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