Individual
KELLY J LUM-NAIHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(602) 839-2686
Mailing address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S025955
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S025955
AZ BOP LICENSE
AZ
Enumeration date
09/20/2022
Last updated
09/20/2022
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