Provider Demographics
NPI:1922864644
Name:KEL HEALTH AND WELLNESS NP INC
Entity Type:Organization
Organization Name:KEL HEALTH AND WELLNESS NP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELECHI
Authorized Official - Middle Name:JOELSON
Authorized Official - Last Name:OKWARAJI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:000-000-0000
Mailing Address - Street 1:2210 NELSON AVE APT D
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-2428
Mailing Address - Country:US
Mailing Address - Phone:240-495-9715
Mailing Address - Fax:
Practice Address - Street 1:1225 CYPRESS AVE STE 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-1112
Practice Address - Country:US
Practice Address - Phone:000-000-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty