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General NPI Number Information
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NPI Number | 1740381243
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Entity Type | Organization
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Legal Business Name | KELLER WELLS AND ASSOCIATES PC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 129 W LAKE MEAD PKWY STE 19
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City | HENDERSON
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State | NV
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Zip | 89015-7055
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Country | US
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Telephone | 702-568-6108
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Fax | 702-568-8603
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Provider Business Mailing Address
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Address Line | PO BOX 530124
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City | HENDERSON
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State | NV
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Zip | 89053-0124
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Country | US
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Telephone | 702-568-6108
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Fax | 702-568-8603
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Authorized Official
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Title or Position | PRESIDENT
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Name | ORLANDIS L WELLS
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Credential | MD
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Telephone | 702-568-6108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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