Individual
MRS. KELLY JO MASTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-RNP
Contact information
Practice address
2175 W 16TH ST UNIT D, SAFFORD, AZ 85546-0842
(928) 651-6372
Mailing address
PO BOX 367, CENTRAL, AZ 85531-0367
(928) 651-6372
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
RN212349
AZ
363LF0000X
Family Nurse Practitioner
Primary
304698
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304698
—
AZ
05
—
RN212349
—
AZ
Enumeration date
02/28/2023
Last updated
03/05/2024
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