MEDICARE: MRS. ELISE KELLY CALL PA-C

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	363A00000X	Physician Assistant	PA1496	NV

General Provider Information

NPI Number	:	1174946701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELISE KELLY CALL PA-C

Provider Business Mailing Address
First Line	:	7200 CATHEDRAL ROCK DR STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0439
Country	:	US
Telephone Number	:	702-341-5444
Fax Number	:	702-341-5445

Provider Business Practice Location Address
First Line	:	7200 CATHEDRAL ROCK DR STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0439
Country	:	US
Telephone Number	:	702-341-5444
Fax Number	:	702-341-5445

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

Provider Enumeration Date	:	02/03/2014
Last Update Date	:	02/25/2026

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Directions to “ MRS. ELISE KELLY CALL PA-C” Practice Location

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