MEDICARE: KELLI MARIE HITE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	95038628	CA
2	363LA2200X	Adult Health Nurse Practitioner	95038628	CA

General Provider Information

NPI Number	:	1922956747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLI MARIE HITE

Provider Business Mailing Address
First Line	:	22616 FENWALL DR
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91350-3655
Country	:	US
Telephone Number	:	661-644-5628
Fax Number	:

Provider Business Practice Location Address
First Line	:	22616 FENWALL DR
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91350-3655
Country	:	US
Telephone Number	:	661-644-5628
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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Directions to “ KELLI MARIE HITE ” Practice Location

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