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General NPI Number Information
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NPI Number | 1821600875
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Entity Type | Individual
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Provider Name | SARA H KELLOGG DNP-FNP
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Gender | Female
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 3655 E GRANT RD
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City | TUCSON
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State | AZ
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Zip | 85716-2933
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Country | US
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Telephone | 520-670-3909
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Fax | 520-309-2560
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Provider Business Mailing Address
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Address Line | 839 W CONGRESS ST
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City | TUCSON
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State | AZ
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Zip | 85745-2819
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Country | US
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Telephone | 520-670-3909
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Fax | 520-309-2560
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 173053
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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 | 311839
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License Number State | AZ
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