Provider Demographics
NPI:1033428255
Name:BILOF, KELLY (MSN, WHNP-C)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:BILOF
Suffix:
Gender:F
Credentials:MSN, WHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20325 N 51ST AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5665
Mailing Address - Country:US
Mailing Address - Phone:602-848-2520
Mailing Address - Fax:602-848-2026
Practice Address - Street 1:20325 N 51ST AVE STE 100
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5665
Practice Address - Country:US
Practice Address - Phone:602-848-2520
Practice Address - Fax:602-848-2026
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3755363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health