MARY GAY KELLEY NURSE PRACTITIONER NPI 1164416277

NPI Information

NPI: 1164416277
Provider Name: MARY GAY KELLEY, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Address:
12425 W BELL RD
SUITE 200
SURPRISE, AZ
ZIP 85378
Phone: (623) 374-7774
Get Directions

Mary Gay Kelley, NURSE PRACTITIONER is a gerontology nurse practitioner in Surprise, AZ. Mary Gay Kelley, NURSE PRACTITIONER NPI is 1164416277. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12425 W BELL RD
SUITE 200
SURPRISE, AZ
ZIP 85378-006
Phone: (623) 374-7774
Fax: (623) 240-1110

The enumeration date for this NPI number is 9/2/2005 and was last updated on 7/11/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	AP2547	ARIZONA	No
2	363LG0600X	Nurse Practitioner	Gerontology	AP0029	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Z121009	MEDICARE UPIN	ARIZONA
2	293709	MEDICAID	ARIZONA
3	P00457902	OTHER	ARIZONA	MEDICARE RR
4	P40021	MEDICARE UPIN	ARIZONA
5	Z144946	MEDICARE PIN	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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