Individual
CATHY KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2030 W WHISPERING WIND DR, PHOENIX, AZ 85085-2853
(602) 866-0550
(602) 993-5788
Mailing address
15650 N BLACK CANYON HWY, SUITE 100, PHOENIX, AZ 85053-4064
(602) 866-0550
(602) 993-5788
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1133
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
387391
—
AZ
Enumeration date
08/22/2005
Last updated
08/22/2011
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