Provider Demographics
NPI:1114581188
Name:EFFREIN, KELSIE SUE (DPM)
Entity Type:Individual
Prefix:DR
First Name:KELSIE
Middle Name:SUE
Last Name:EFFREIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8899 E PALM TREE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-9290
Mailing Address - Country:US
Mailing Address - Phone:515-444-7361
Mailing Address - Fax:
Practice Address - Street 1:19636 N 27TH AVE STE 301
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4016
Practice Address - Country:US
Practice Address - Phone:602-993-2700
Practice Address - Fax:313-745-1520
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPOD001050213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery