Individual
DR. KELLY M CHURCHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AUD, CCC-A
Contact information
Practice address
4351 E LOHMAN AVE STE 103, LAS CRUCES, NM 88011-8258
(575) 521-9795
Mailing address
4351 E LOHMAN AVE STE 103, LAS CRUCES, NM 88011-8258
(575) 521-9795
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1807
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K2358
—
NM
Enumeration date
10/05/2006
Last updated
07/02/2019
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