Kennelly, Lisa Ann

Kennelly, Lisa Ann is an individual health care provider with primary practice located at 16931 Bayou Ln , Fontana CA 92336-2199. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Kennelly, Lisa Ann can be contacted via phone (909) 921-3072.

Contact Information

Primary practice address
16931 Bayou Ln Fontana CA 92336-2199
Phone: (909) 921-3072
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 95009012 California

Profile Details

NPI number 1508352972
LBN Legal business name Kennelly, Lisa Ann
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2018
Last updated Jul 9th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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