Individual
MRS. MARY ELLEN KENWORTHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
Mailing address
2525 E ROOSEVELT ST, PHOENIX, AZ 85008-4948
(602) 344-1015
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
AP00853
AZ
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
RN043733
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
760406
—
AZ
Enumeration date
01/15/2006
Last updated
09/12/2025
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