MEDICARE: KELLI LYNNE LEJA FNP-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	363LF0000X	Family Nurse Practitioner	SP022198	PA

General Provider Information

NPI Number	:	1558971887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLI LYNNE LEJA FNP-C

Provider Business Mailing Address
First Line	:	4003 PENN AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15224-1337
Country	:	US
Telephone Number	:	724-201-6970
Fax Number	:	877-384-3106

Provider Business Practice Location Address
First Line	:	4003 PENN AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15224-1337
Country	:	US
Telephone Number	:	724-201-6970
Fax Number	:	877-384-3106

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

Provider Enumeration Date	:	08/02/2020
Last Update Date	:	05/02/2025

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