Individual
KELSY GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 PAWNEE DR, LAKE HAVASU CITY, AZ 86406-8764
(928) 505-6082
Mailing address
821 THUNDERBOLT AVE, LAKE HAVASU CITY, AZ 86406-7102
(928) 486-9851
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN209455
AZ
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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