Individual
DR. KELLY ANN BENEDICT
Active
Individual
DR. KELLY ANN BENEDICT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
49162
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
921982
—
AZ
Enumeration date
07/13/2007
Last updated
03/01/2017
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