Individual
ADRIENNE J KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
3033 N 44TH ST STE 100, PHOENIX, AZ 85018-7227
(602) 631-3161
(602) 631-3162
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3487
AZ
363AS0400X
Surgical Physician Assistant
3487
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162787
—
AZ
Enumeration date
10/17/2006
Last updated
07/29/2022
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