Provider Demographics
NPI:1619599156
Name:MENDELSOHN, KELLY ALLYN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ALLYN
Last Name:MENDELSOHN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3550 N 1ST AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1722
Mailing Address - Country:US
Mailing Address - Phone:520-724-7900
Mailing Address - Fax:520-724-5343
Practice Address - Street 1:3550 N 1ST AVE STE 300
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1722
Practice Address - Country:US
Practice Address - Phone:520-724-7900
Practice Address - Fax:520-724-5343
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAZ135234163W00000X
AZ248859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse