Individual
KEEGAN ASHLEY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8880 E DESERT COVE AVE, SCOTTSDALE, AZ 85260-6746
(480) 314-6670
(480) 314-6699
Mailing address
PO BOX 6423, CHANDLER, AZ 85246-6423
(480) 314-6670
(480) 257-1997
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10173
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293629
—
AZ
Enumeration date
06/30/2017
Last updated
11/14/2022
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