Most Relevant Information
Provider Data
| NPI Number: | 1003480179 |
| Provider Name: | KELLY KOEHLER APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 835198 |
Most Important Dates
| Enumeration Date: | 05/13/2021 |
| Last Updated: | 05/13/2021 |
Provider Practice Location
3150 N TENAYA WAY STE 135
LAS VEGAS
NV
891280463
Practice Location Phone/Fax
| Phone: | 7025983999 |
| Fax: |
Provider Mailing Location
10414 SKYE CANYON FALLS AVE
LAS VEGAS
NV
891661208
Provider Mailing Phone/Fax
| Phone: | 9285305566 |
| Fax: |