| Doctor Name: | KELLI ZACKARY |
| NPI Number: | 1255714341 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 668899 |
| Business Practice Address: | 3521b Cannon Dr Twentynine Palms, CA - 922779470 |
| Business Phone Number: | 8087829946 |
| Business Fax Number: | |
| Mailing Address: | 3521b Cannon Dr, TWENTYNINE PALMS |
| State: | CA |
| Postal Code: | 922779470 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/07/2015 |
| NPI Last Update Date: | 07/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WL0100X |
| License Number: | 668899 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Lactation Consultant |
| Taxonomy Definition: | |