Individual provider · Type 1 NPI

Kelly Fons Borman, NP

Pediatric Nurse Practitioner · Los Angeles, CA

NPI number 1982004792 Active

Practice location

4650 W Sunset Blvd # 54
Los Angeles, CA 90027-6062

Fax (323) 361-8767

Mailing address

4249 Stern Ave
Sherman Oaks, CA 91423-4226

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X740170 (CA)
Pediatric Nurse Practitioner Primary 363LP0200X21393 (CA)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1982004792

Kelly Fons Borman, NP's National Provider Identifier is 1982004792, issued on Aug 28, 2014. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Los Angeles, CA. The record was last updated on Jun 18, 2015.