Individual
DR. KELLIE LYNN ARVISO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 779-3366
Mailing address
1200 N BEAVER ST, ATTN: PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
72676
AZ
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
MD2015-0395
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/13/2011
Last updated
04/09/2026
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