Individual
DR. NICOLE RENEE KELLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
531 E LYNWOOD ST, PHOENIX, AZ 85004-1626
(603) 660-8972
(602) 626-3555
Mailing address
10435 N SCOTTSDALE RD, SCOTTSDALE, AZ 85253-4530
(603) 660-8972
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
09-1131
AZ
Other
Enumeration date
03/28/2007
Last updated
08/20/2013
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