Provider Demographics
NPI:1508146366
Name:KESSAY, AUDREY J (RN)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:J
Last Name:KESSAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WEST HOPSITAL DRIVE PO BOX 860
Mailing Address - Street 2:INDIAN HEALTH SERVICE
Mailing Address - City:WHITERIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85941
Mailing Address - Country:US
Mailing Address - Phone:928-338-3684
Mailing Address - Fax:928-338-3681
Practice Address - Street 1:200 WEST HOSPITAL DRIVE
Practice Address - Street 2:PHN DEPARTMENT
Practice Address - City:WHITERIVER
Practice Address - State:AZ
Practice Address - Zip Code:85941
Practice Address - Country:US
Practice Address - Phone:928-338-4911
Practice Address - Fax:928-338-3681
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN065782163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health