Provider Demographics
NPI:1932264736
Name:RAMSDELL, KELLY
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:RAMSDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 W STEPHENS PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-3136
Mailing Address - Country:US
Mailing Address - Phone:480-634-7253
Mailing Address - Fax:
Practice Address - Street 1:3109 W STEPHENS PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3136
Practice Address - Country:US
Practice Address - Phone:480-634-7253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1849174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist