Individual
MELISSA MARIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 445-4860
Mailing address
12969 E GONZALEZ ST, DEWEY, AZ 86327-8299
(602) 717-1165
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN171106
AZ
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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