Doctor Name: | MRS. KELLY MICHELLE CENICEROS |
NPI Number: | 1306061700 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | RN115568 |
Business Practice Address: | 6849 E. Hwy 92 Hereford, AZ - 856150038 |
Business Phone Number: | 5203665508 |
Business Fax Number: | 5203665592 |
Mailing Address: | Po Box 38, HEREFORD |
State: | AZ |
Postal Code: | 856150038 |
Phone Number: | 5203665508 |
Fax Number: | 5203665592 |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | RN115568 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |