Individual
KELLY JO LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1510 N STOCKTON HILL RD, KINGMAN, AZ 86401-5173
(928) 753-1177
(928) 753-1177
Mailing address
PO BOX 1231, TUCSON, AZ 85702-1231
(520) 670-3909
(520) 309-2560
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
307837
AZ
Other
Enumeration date
04/12/2019
Last updated
05/01/2026
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