MS. THERESA KELSO NURSE PRACTITIONER NPI 1336201219

NPI Information

NPI: 1336201219
Provider Name: MS. THERESA KELSO, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
5616 E MAIN ST
MESA, AZ
ZIP 85205
Phone: (480) 396-3222
Get Directions

MS. Theresa Kelso, NURSE PRACTITIONER is a family nurse practitioner in Mesa, AZ. MS. Theresa Kelso, NURSE PRACTITIONER NPI is 1336201219. 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:

5616 E MAIN ST
MESA, AZ
ZIP 85205-813
Phone: (480) 396-3222
Fax: (480) 396-2298

The enumeration date for this NPI number is 12/15/2006 and was last updated on 5/4/2011.

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	RN095337	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	167693	MEDICAID	ARIZONA
2	1336201219	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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