Kelly J Archambeau, RN
Individual provider Active NPI Community Health Registered Nurse · San Carlos, AZ
NPI 1194846428 · NPPES record last updated Feb 16, 2011
Key facts
- NPI
- 1194846428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Registered Nurse 163WC1500X
- License
- RN075058 (AZ)
- Practice address
- 223 Seneca Lane
San Carlos, AZ 85550 - Phone
- (928) 475-7338
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN075058 | AZ | MD | Community Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | RN075058 | AZ | Yes |
Addresses
Primary practice location
223 Seneca Lane
San Carlos, AZ 85550
Mailing address
252 N Fourth St
Globe, AZ 85501-1204
Phone (928) 425-0202
Other providers in San Carlos, AZ
All providers in San Carlos, AZ · Community Health Registered Nurse in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.