Individual provider · Type 1 NPI

Lisa Kelllum, RN BSN PHN

Case Management Registered Nurse · San Diego, CA

NPI number 1629107586 Active

Practice location

2440 Grand Ave
San Diego, CA 92109-4858

Specialties and licenses

Taxonomy	Code	License
Case Management Registered Nurse Primary	163WC0400X	RN469227 (CA)

Case Management Registered Nurse: Definition to come...

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About NPI 1629107586

Lisa Kelllum, RN BSN PHN's National Provider Identifier is 1629107586, issued on Mar 5, 2007. The primary taxonomy on file is Case Management Registered Nurse (163WC0400X), and the practice location is in San Diego, CA. The record was last updated on Jul 8, 2007.