Individual
MISS KELLY RENEE GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1910 E THOMAS RD STE 200, PHOENIX, AZ 85016-7767
(602) 266-2200
(602) 604-6134
Mailing address
1910 E THOMAS RD STE 200, PHOENIX, AZ 85016-7767
(602) 266-2200
(602) 604-5032
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN066578
AZ
Other
Enumeration date
12/04/2006
Last updated
10/21/2019
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