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Individual

KELSEY JEWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1489 S HIGLEY RD, 101, GILBERT, AZ 85296
(480) 457-8800
(480) 457-8885
Mailing address
1489 S HIGLEY RD, 101, GILBERT, AZ 85296-4776
(480) 457-8800
(480) 457-8885

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6460
AZ
363A00000X
Physician Assistant
6460
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
206469
AZ
Enumeration date
10/10/2016
Last updated
05/30/2018
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