MEDICARE: KELSEY MCKEEVER RN

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	163W00000X	Registered Nurse	95237547	CA

General Provider Information

NPI Number	:	1487242277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY MCKEEVER RN

Provider Business Mailing Address
First Line	:	8039 CLEMENS AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91304-3512
Country	:	US
Telephone Number	:	818-493-0811
Fax Number	:

Provider Business Practice Location Address
First Line	:	8039 CLEMENS AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91304-3512
Country	:	US
Telephone Number	:	818-493-0811
Fax Number	:

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

Provider Enumeration Date	:	01/06/2021
Last Update Date	:	01/06/2021

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