Provider Demographics
NPI:1558971887
Name:LEJA, KELLI LYNNE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:LYNNE
Last Name:LEJA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:LYNNE
Other - Last Name:GILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 DUNCAN AVE # 10034
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5854
Mailing Address - Country:US
Mailing Address - Phone:412-358-8690
Mailing Address - Fax:
Practice Address - Street 1:611 DUNCAN AVE # 10034
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5854
Practice Address - Country:US
Practice Address - Phone:412-358-8690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-02
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022198363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily