NPI Search for Physicians and Health Care Providers
MR. KELLY MARCUM NP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1619973930
Individual Registrant:
MR. KELLY MARCUM NP
Gender: M
Not Sole Proprietor
Location and contact information for practice:
2931 S HWY 260 OVERGAARD, AZ 85933 US
Tel: 928-536-3616 Fax: 928-536-3615
Contact information for business:
2200 E SHOW LOW LAKE RD SHOW LOW, AZ 85901 US
Tel: 928-537-6978 Fax: 928-537-4205
Registration Information:
NPI: 1619973930
Entity Type: Individual
Specialty information:
Primary | Code | Category/Description | State | License Number |
---|
Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | AZ | RN036514 |
Legacy codes, insurance codes and state license numbers:
HEALTH CARE JOBS AZ - Page 1