Healthcare Provider Details

I. General information

NPI: 1245614718
Provider Name (Legal Business Name): KELLER- WELLS & ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2637 W HORIZON RIDGE PKWY STE 130
HENDERSON NV
89052-4835
US

IV. Provider business mailing address

PO BOX 530124
HENDERSON NV
89053-0124
US

V. Phone/Fax

Practice location:
  • Phone: 702-568-6108
  • Fax: 702-479-4881
Mailing address:
  • Phone: 702-568-6108
  • Fax: 702-487-5773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number10558
License Number StateNV

VIII. Authorized Official

Name: DR. ORLANDIS L WELLS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 702-568-6108