Individual
MARY GAY KELLEY
Active
Individual
MARY GAY KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP2547
AZ
363LG0600X
Gerontology Nurse Practitioner
Primary
AP0029
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293709
—
AZ
01
—
P00457902
MEDICARE RR
AZ
Enumeration date
09/02/2005
Last updated
07/11/2011
Update your record
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