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Individual

KELLI SUE THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
18555 N 79TH AVE STE D101, GLENDALE, AZ 85308-6040
(480) 563-8009
(480) 563-8009
Mailing address
9977 N 90TH ST STE 350, SCOTTSDALE, AZ 85258-4434
(480) 245-6126
(480) 563-8009

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP11562
AZ
363LF0000X
Family Nurse Practitioner
AP128449
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
356798401
TX
Enumeration date
03/01/2016
Last updated
08/22/2018
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