Provider Demographics
NPI:1790363182
Name:TWILLING, KELLY ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:TWILLING
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 S RIVER DR UNIT 33
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3334
Mailing Address - Country:US
Mailing Address - Phone:480-206-9443
Mailing Address - Fax:
Practice Address - Street 1:10290 N 92ND ST STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4508
Practice Address - Country:US
Practice Address - Phone:480-425-4150
Practice Address - Fax:480-657-3491
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRNP256015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily