Individual
KELLY MARIE MULHOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6036 N 19TH AVE STE 204, PHOENIX, AZ 85015-2104
(480) 616-0356
(480) 616-0603
Mailing address
P.O BOX 29650, DEPT # 880391, PHOENIX, AZ 85038-2690
(480) 626-1746
(480) 626-2690
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
301586
AZ
363LF0000X
Family Nurse Practitioner
301586
AZ
Other
Enumeration date
02/09/2024
Last updated
06/13/2024
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