Individual
KELLY A HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4502 N CENTRAL AVE, PHOENIX, AZ 85012-1817
(602) 764-1100
Mailing address
4502 N CENTRAL AVE, PHOENIX, AZ 85012-1817
(602) 764-1100
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN094982
AZ
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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