Provider Demographics
NPI:1225351596
Name:KELLY, DENISE MARY (RN)
Entity Type:Individual
Prefix:MR
First Name:DENISE
Middle Name:MARY
Last Name:KELLY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:9066 E 29TH ST
Mailing Address - Street 2:MARSHALL ELEMENTARY
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-8010
Mailing Address - Country:US
Mailing Address - Phone:520-731-4947
Mailing Address - Fax:520-731-4901
Practice Address - Street 1:9066 E 29TH ST
Practice Address - Street 2:MARSHALL ELEMENTARY
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-8010
Practice Address - Country:US
Practice Address - Phone:520-731-4947
Practice Address - Fax:520-731-4901
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN156762163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse