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General NPI Number Information
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NPI Number | 1932019072
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Entity Type | Individual
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Provider Name | KELLY EHRHARDT RN
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Gender | Female
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 223 NEWELL DR
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City | FORTUNA
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State | CA
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Zip | 95540-2212
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Country | US
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Telephone | 310-634-0556
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 922
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City | FORTUNA
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State | CA
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Zip | 95540-0922
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Country | US
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Telephone | 310-634-0553
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 798144
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License Number State | CA
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