Individual
KELLY L SCOGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5310 W THUNDERBIRD RD, SUITE 110, GLENDALE, AZ 85306-4706
(602) 865-4065
Mailing address
5310 W THUNDERBIRD RD, SUITE 110, GLENDALE, AZ 85306-4706
(602) 865-4065
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
124662
AZ
163WP0200X
Pediatric Registered Nurse
RN124662
AZ
208600000X
Surgery Physician
Primary
124662
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
826737
—
AZ
Enumeration date
11/03/2006
Last updated
02/04/2014
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