Kelley, Mary Gay

Kelley, Mary Gay is an individual health care provider with primary practice located at 12425 W Bell Rd Suite 200, Surprise AZ 85378-9006. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Kelley, Mary Gay can be contacted via phone (623) 374-7774.

Contact Information

Primary practice address
12425 W Bell Rd Suite 200 Surprise AZ 85378-9006
Phone: (623) 374-7774
Fax: (623) 240-1110
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X AP0029 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP2547 Arizona

Profile Details

NPI number 1164416277
LBN Legal business name Kelley, Mary Gay
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Jul 11th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164416277 NPPES
Arizona MEDICAID 293709
Arizona Other P00457902

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