| Li Kelly, | |
|
2360 E Bidwell St Ste 105, Folsom, CA 95630-3406 | |
| (855) 501-1004 | |
| Not Available |
| Full Name | Li Kelly |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 2360 E Bidwell St Ste 105, Folsom, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033972815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 95028882 (California) | Primary |
| Entity Name | Ehab Yacoub MD Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417373713 PECOS PAC ID: 5092099523 Enrollment ID: O20170301002071 |
| Entity Name | Grow Healthcare Group PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080 |
| Mailing Address | Practice Location Address |
|---|---|
| Li Kelly, 3835 N Freeway Blvd Ste 100, Sacramento, CA 95834-1954 Ph: Not Available | Li Kelly, 2360 E Bidwell St Ste 105, Folsom, CA 95630-3406 Ph: (855) 501-1004 |
Alaina Rae Niebuhr, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1580 Creekside Dr Ste 250, Folsom, CA 95630 Phone: 916-983-8695 |
Karen Tang, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1641 Creekside Dr Ste 201, Folsom, CA 95630 Phone: 916-983-3069 |
Sally Kei Mason, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 510 Plaza Dr Ste 170, Folsom, CA 95630 Phone: 916-351-9400 |
Annika Elizabeth Dethlefs, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 82 Clarksville Rd Ste 120, Folsom, CA 95630 Phone: 916-983-8868 |
Miss Jennifer N Okechukwu, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 510 Plaza Dr Ste 170, Folsom, CA 95630 Phone: 916-351-9400 |
Mrs. Josephine P Williams, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 108 Lowney Ct, Folsom, CA 95630 Phone: 916-984-3792 |
Mrs. Harrieth Amaka Madu, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 510 Plaza Dr Ste 170, Folsom, CA 95630 Phone: 916-351-9400 Fax: 916-351-9449 |