Individual
KELLY MICHELE CZARNECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1490 N TURQUOISE DR, FLAGSTAFF, AZ 86001
(928) 774-5074
(928) 774-0884
Mailing address
1490 N TURQUOISE DR, FLAGSTAFF, AZ 86001
(928) 774-5074
(928) 774-0884
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56246
—
AZ
Enumeration date
07/27/2006
Last updated
01/11/2022
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