Individual
KACEY M EKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1680 S 20TH AVE, SAFFORD, AZ 85546-4011
(928) 428-1377
Mailing address
1680 S 20TH AVE, SAFFORD, AZ 85546-4011
(928) 428-1377
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP2760
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
778563
—
AZ
Enumeration date
07/21/2007
Last updated
06/26/2014
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