Individual
KELTON CREST MERRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10401 W THUNDERBIRD BLVD, SUN CITY, AZ 85351-3004
(623) 832-4000
Mailing address
18853 N 59TH DR, GLENDALE, AZ 85308-7604
(928) 245-5056
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN208298
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
298194
AZ
Other
Enumeration date
09/18/2023
Last updated
12/22/2023
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