Provider Demographics
NPI:1689990145
Name:MCKELVEY, JESSICA RUTH (DC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:RUTH
Last Name:MCKELVEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:RUTH
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:370 CASA NORTE DR UNIT 2121
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3332
Mailing Address - Country:US
Mailing Address - Phone:725-910-2935
Mailing Address - Fax:
Practice Address - Street 1:4116 W CRAIG RD STE 100
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2733
Practice Address - Country:US
Practice Address - Phone:702-655-1199
Practice Address - Fax:702-646-0630
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor