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General NPI Number Information
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NPI Number | 1790450229
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Entity Type | Individual
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Provider Name | ASHLEY KELEPOLO NP
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Gender | Female
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Dates
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Enumeration Date | 08/16/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 625 N 13TH W
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City | SAINT JOHNS
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State | AZ
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Zip | 85936-4986
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Country | US
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Telephone | 928-337-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 714 W AIRPORT RD
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City | SPRINGERVILLE
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State | AZ
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Zip | 85938-5013
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Country | US
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Telephone | 480-258-0481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 262356
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F07211457
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License Number State | AZ
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