Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
MS. TRACI L KELLY
Active
Individual
MS. TRACI L KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., F.N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN0604
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120390
GROUP MEDICARE NUMBER
AZ
01
—
317047
GROUP MEDICAID NUMBER
AZ
Enumeration date
05/12/2006
Last updated
05/21/2008
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