DR. LUANNE TAKACS KELLY


Address: 2400 W Dunlap Ave Ste 125, Phoenix, AZ 85021-2885
Phone: 5203408686

DR. LUANNE TAKACS KELLY (NPI# 1073849360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073849360
Entity Type Individual
Full Name DR. LUANNE TAKACS KELLY
Credential NP
Practice Address 2400 W Dunlap Ave Ste 125
Phoenix
AZ 85021-2885
Mailing Address 14609 N 60th Ave
Glendale
AZ 85306-3805
Practice Telephone 5203408686
Practice Fax Number 6237380425
Mailing Telephone 5203408686
Mailing Fax Number 6237384025
Enumeration Date 2009-10-22
Last Update Date 2020-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
AP3594 AZ Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AZ 1073849360 05
AZ 618876 05
PA NP LICENSE UP80001B 01
AZ ANCC 048119 01
AZ ARIZONA BOARD OF NURSING AP3594 01
AZ MEDICARE Z25025 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
20860 N Tatum Blvd Ste 300, Phoenix, AZ 850504283 5203408686 5203408686

Office Location

Street Address 2400 W DUNLAP AVE STE 125
City PHOENIX
State AZ
Zip Code 85021-2885

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205476868 Bowser's Garden LLC Nurse Practitioner 2400 W Dunlap Ave Ste 125, Phoenix, AZ 85021-2885 2020-01-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679173181 Jill M Robinson Social Worker 8804 N. 23rd Ave, Bldg. A Ste. A01-a02, Phoenix, AZ 85021 2020-10-26
1528671013 Sabrina Mcninch Behavior Technician 1200 W Dunlap Ave, Ste 100, Phoenix, AZ 85021 2020-08-25
1376169938 Maricopa County Special Heallth Care District Pharmacy 2025 W Northern Ave, Phoenix, AZ 85021 2020-06-19
1841832664 Madison Westby Physical Therapist 717 W Dunlap Ave # 100, Phoenix, AZ 85021 2019-10-14
1861967481 Southwest Family Naturopathic Clinic Pllc Naturopath 1530 W Glendale Ave Suite 103, Phoenix, AZ 85021 2018-10-10
1184101461 Genoa Healthcare, LLC Durable Medical Equipment & Medical Supplies 8804 N 23rd Ave, Suite A01/a02, Phoenix, AZ 85021 2018-07-19
1568970150 Alycia Ann Poloni Occupational Therapist 7129 N 23d Ave, Phoenix, AZ 85021 2018-01-17
1154839165 Cyrus Professional Corporation Dentist 2401 W. Glendale Ave, Ste 102, Phoenix, AZ 85021 2018-01-12
1568980779 Marla Jean Clay Licensed Practical Nurse 1717 W. Glendale Ave. Apt. 3011, Phoenix, AZ 85021 2017-09-07
1801325162 Kaitlin King Nurse Practitioner 8824 N 9th Ave, Phoenix, AZ 85021 2017-06-08
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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1942819230 Care On Pllc Nurse Practitioner 7171 S 51 Ave, Phoenix, AZ 85339-2923 2020-07-23
1558985036 Amanda Stanford Nurse Practitioner 925 E Mc Dowell Rd, Phoenix, AZ 85006 2020-06-01
1710522024 Kelsey Conrad Nurse Practitioner 1 E Lexington Ave Unit 1602, Phoenix, AZ 85012-4203 2019-11-11
1124662408 Rayiom Health and Wellness, Inc Nurse Practitioner 11225 N 28th Dr Ste A102-22, Phoenix, AZ 85029-5606 2019-10-30
1699259580 Keith Dibenedetto Nurse Practitioner 2617 Stockton Rd, Phoenix, MD 21131-1117 2018-09-18
1467975698 Samantha June Collett Nurse Practitioner 3201 W Peoria Ave Ste 804, Phoenix, AZ 85029 2017-07-19
1598135741 Sandra Shearer Nurse Practitioner 513 W Lavitt Ln, Phoenix, AZ 85086-6346 2015-09-30
1023499860 Kelly Lynn Schultz Nurse Practitioner 3944 E Hillery Dr, Phoenix, AZ 85032-5245 2015-06-17
1609298900 Lorna Ann Hill Nurse Practitioner 13224 N 31st Pl, Phoenix, AZ 85032-6041 2014-01-06
1801217765 Trifit Pain Management LLC Nurse Practitioner 505 E Camelback Rd, Phoenix, AZ 85012-1615 2013-12-19
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Competitor

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City PHOENIX
Zip Code 85021

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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