MEDICARE: DUCRAY WELLNESS, LLC

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
1	363LA2100X	Acute Care Nurse Practitioner

General Provider Information

NPI Number	:	1144152711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUCRAY WELLNESS, LLC

Provider Business Mailing Address
First Line	:	22838 E TWILIGHT DR
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-2184
Country	:	US
Telephone Number	:	480-202-4044
Fax Number	:	480-522-3444

Provider Business Practice Location Address
First Line	:	22838 E TWILIGHT DR
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-2184
Country	:	US
Telephone Number	:	480-202-4044
Fax Number	:	480-522-3444

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	KELLI DUCRAY
Credential	:	ACNP-BC
Telephone Number	:	480-202-4044

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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