Individual
KELLY ANNE POLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9003 E SHEA BLVD, SCOTTSDALE, AZ 85260-6709
(480) 323-3350
Mailing address
13601 W PINCHOT AVE, AVONDALE, AZ 85392-3552
(602) 980-4449
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN063628
AZ
Other
Enumeration date
05/15/2007
Last updated
09/25/2007
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