Individual
KELLY MARIE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1920 E CAMBRIDGE AVE STE 302, PHOENIX, AZ 85006-1464
(602) 933-5200
(602) 933-4272
Mailing address
3200 E CAMELBACK RD STE 250, PHOENIX, AZ 85018-2327
(602) 933-1814
(602) 933-1820
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1882
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
317281-04
—
AZ
Enumeration date
01/18/2006
Last updated
01/26/2018
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