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General NPI Number Information
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NPI Number | 1437526894
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Entity Type | Individual
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Provider Name | KELLI S LANDRUM FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 805 FRONTAGE RD
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City | KENAI
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State | AK
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Zip | 99611
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Country | US
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Telephone | 907-283-3600
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Fax | 907-283-3601
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Provider Business Mailing Address
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Address Line | PO BOX 2949
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City | SOLDOTNA
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State | AK
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Zip | 99669-2949
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Country | US
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Telephone | 907-260-7303
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Fax | 907-260-7301
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 227339
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201506440NP-PP
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 133545
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License Number State | AK
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