Individual
CASEY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7242 N 77TH DR, GLENDALE, AZ 85303-2015
(772) 924-5835
Mailing address
7242 N 77TH DR, GLENDALE, AZ 85303-2015
(561) 319-2350
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
273181
AZ
Other
Enumeration date
01/02/2023
Last updated
01/02/2023
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