Individual
KAYLA MARIE SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2163 E BASELINE RD STE 101, TEMPE, AZ 85283-1541
(480) 646-8123
(480) 646-8125
Mailing address
2163 E BASELINE RD STE 101, TEMPE, AZ 85283-1541
(480) 646-8123
(480) 646-8125
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6265
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115413
—
AZ
Enumeration date
08/07/2012
Last updated
07/21/2022
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