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1508352972
LISA ANN KENNELLY
FONTANA, CA
NPI
1508352972
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: CA 95009012)
Enumeration Date
2018-07-09
Last Update Date
2018-07-09
Business Address
LISA ANN KENNELLY NP
16931 BAYOU LN
FONTANA, CA 92336-2199
Phone number: 909-921-3072
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Mailing Address
LISA ANN KENNELLY NP
16931 BAYOU LN
FONTANA, CA 92336-2199
Phone number: 909-921-3072
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