Individual
MRS. KELLI ANN MERCADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2700 N 140TH AVE STE 107, GOODYEAR, AZ 85395-2439
(623) 535-8770
(623) 535-8771
Mailing address
2700 N 140TH AVE STE 107, GOODYEAR, AZ 85395-2439
(623) 535-8770
(623) 535-8771
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3060
AZ
363AS0400X
Surgical Physician Assistant
3060
AZ
Other
Enumeration date
10/03/2006
Last updated
01/16/2019
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