Individual
KELLY M KOLLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
8761 E BELL RD, SUITE 105, SCOTTSDALE, AZ 85260-1315
(480) 219-6662
(480) 219-6596
Mailing address
P.O. BOX 29901, DEPT. 994, PHOENIX, AZ 85038-0901
(480) 219-6662
(480) 219-6662
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3449
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160229
—
AZ
01
—
P00624725
RAILROAD MEDICARE
AZ
Enumeration date
11/24/2006
Last updated
03/15/2011
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