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Individual
DR. KRISTA DEANN PELLICORE
Active
Individual
DR. KRISTA DEANN PELLICORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01057388A
IN
207Q00000X
Family Medicine Physician
Primary
48328
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000305690
BCBS PROVIDER NUMBER
—
05
—
200447730
—
IN
05
—
857797
—
AZ
Enumeration date
06/18/2006
Last updated
04/22/2025
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