Individual
MRS. KELLY MICHELLE CENICEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
6849 E. HWY 92, HEREFORD, AZ 85615-0038
(520) 366-5508
(520) 366-5592
Mailing address
PO BOX 38, HEREFORD, AZ 85615-0038
(520) 366-5508
(520) 366-5592
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN115568
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
636045
—
AZ
Enumeration date
04/13/2007
Last updated
07/08/2007
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