Individual
KELLIE S WEBSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10120 S EASTERN AVE STE 315, HENDERSON, NV 89052-3954
(725) 301-3138
Mailing address
1208 SIMMS AVE, HENDERSON, NV 89074-8094
(725) 301-3138
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
875194
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-31815
MEDICARE
—
01
—
Z90638
MEDICARE
—
01
—
ZFQ31815
MEDICARE
—
Enumeration date
03/04/2009
Last updated
07/17/2026
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