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NPI Code Detail

MEDICARE: ASHLEY THOMPSON KELLOGG

MEDICARE:   ASHLEY THOMPSON KELLOGG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner264728AZ

General Provider Information

NPI Number : 1164352050
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY THOMPSON KELLOGG
Provider Business Mailing Address
First Line : 20897 E VIA DEL JARDIN CT
Second Line :
City : QUEEN CREEK
State : AZ
Zip : 85142-5217
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20897 E VIA DEL JARDIN CT
Second Line :
City : QUEEN CREEK
State : AZ
Zip : 85142-5217
Country : US
Telephone Number : 480-310-8554
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2026
Last Update Date : 05/21/2026

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Directions to “ ASHLEY THOMPSON KELLOGG ” Practice Location

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