Individual
KELLI BROOKE FOLGHERAITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2078 WILLOW CREEK RD, PRESCOTT, AZ 86301-5389
(928) 776-6400
(855) 633-3142
Mailing address
2078 WILLOW CREEK RD, PRESCOTT, AZ 86301-5389
(928) 776-6400
(855) 633-3142
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
260085
AZ
Other
Enumeration date
07/28/2021
Last updated
04/12/2023
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