Individual
DR. LUANNE TAKACS KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2400 W DUNLAP AVE STE 125, PHOENIX, AZ 85021-2885
(520) 340-8686
(623) 738-0425
Mailing address
2400 W DUNLAP AVE STE 125, PHOENIX, AZ 85021-2885
(602) 698-7597
(623) 738-4025
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP3594
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048119
ANCC
AZ
05
—
1073849360
—
AZ
05
—
618876
—
AZ
01
—
AP3594
ARIZONA BOARD OF NURSING
AZ
01
—
UP80001B
NP LICENSE
PA
01
—
Z25025
MEDICARE
AZ
Enumeration date
10/22/2009
Last updated
08/18/2025
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