Healthcare Provider Details

I. General information

NPI: 1689002115
Provider Name (Legal Business Name): KELSY J ROKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2013
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 E FLORENCE BLVD STE 120
CASA GRANDE AZ
85122-4765
US

IV. Provider business mailing address

3300 N 75TH ST
SCOTTSDALE AZ
85251-6411
US

V. Phone/Fax

Practice location:
  • Phone: 520-426-1000
  • Fax:
Mailing address:
  • Phone: 480-941-5656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number5501
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number5501
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5501
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: