Organization
LEGACY WELLNESS PLLC
Active
Other names
Legacy Wellness PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN KELLY FNP (PROVIDER)
(623) 792-3584
Entity
Organization
Contact information
Practice address
19841 N 27TH AVE STE 204, PHOENIX, AZ 85027-4005
(623) 792-3584
Mailing address
PO BOX 46, PEORIA, AZ 85380-0046
(623) 792-3584
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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