MRS. KELLY MAUREEN BLUNK (NPI# 1790977353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790977353 |
| Entity Type | Individual |
| Full Name | MRS. KELLY MAUREEN BLUNK |
| Credential | M.S. |
| Practice Address |
3333 W Roosevelt St Phoenix AZ 85009-3403 |
| Mailing Address |
4502 N Central Ave Phoenix AZ 85012-1817 |
| Practice Telephone | 6027643000 |
| Practice Fax Number | 6024525825 |
| Mailing Telephone | 6027641100 |
| Mailing Fax Number | 6024071159 |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2009-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
3842151 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
3333 W ROOSEVELT ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85009-3403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225168909 | Raul Torres | Specialist | 3333 W Roosevelt St, Phoenix, AZ 85009-3403 | 2007-03-06 |
| 1396267829 | Tracy Ann Tully | Speech-Language Pathologist | 3333 W Roosevelt St, Phoenix, AZ 85009-3403 | 2017-07-17 |
| 1285874552 | Michael Durell Morris | Counselor | 3333 W Roosevelt St, Phoenix, AZ 85009-3403 | 2009-02-26 |
| 1659519544 | George A Torres | Counselor | 3333 W Roosevelt St, Phoenix, AZ 85009-3403 | 2009-01-30 |
| 1801012430 | Barbara M Davis | Counselor | 3333 W Roosevelt St, Phoenix, AZ 85009-3403 | 2007-04-18 |
| 1699898155 | Julia Elizabeth Browning | Speech-Language Pathologist | 3333 W Roosevelt St, Phoenix, AZ 85009-3403 | 2007-04-09 |
| 1205953262 | Dennis Patrick Cronin | Social Worker | 3333 W Roosevelt St, Phoenix, AZ 85009-3403 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220065 | Ashley Medeiros | Specialist/Technologist | 2926 E. Encanto Blvd., Phoenix, AZ 85009 | 2020-09-16 |
| 1326252909 | Raul Herreras | Speech-Language Pathologist | 3101 W. Mcdowell Road, Phoenix, AZ 85009 | 2007-05-10 |
| 1295956779 | Gerardo Gaerlan Gregorio | Internal Medicine | 3250 W. Lower Buckeye Road, Phoenix, AZ 85009 | 2007-05-01 |
| 1316060338 | Eve Ronnie Davidson | Registered Nurse | 3333wroosevelt, Phoenix, AZ 85009 | 2007-04-06 |
| 1679693808 | Paul Thomas Lorentsen | Internal Medicine | 1929 W. Fillmore St, Bldg C, The Neighborhood Christian Clinic, Phoenix, AZ 85009 | 2007-03-30 |
| 1134246655 | Audrea J Chambers-pryce | Registered Nurse | 3715 W Roosevelt, Phx, AZ 85009 | 2007-03-22 |
| 1053437582 | Monique Marie Knepper | Licensed Practical Nurse | 3025 W Mc Dowell Rd, Phoenix, AZ 85009 | 2007-03-22 |
| 1245356054 | Lena Rose Felder | Speech-Language Pathologist | 3348 W. Mcdowell Rd., Phoenix, AZ 85009 | 2007-03-22 |
| 1508900036 | Walter M Wood | Psychologist | 3348 W Mcdowell Road, Phoenix, AZ 85009 | 2007-02-17 |
| 1194869982 | Maureen Brukardt | Registered Nurse | 3449 N 39th Ave, Phx, AZ 85009 | 2007-02-16 |
| Find all providers in zip 85009 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386171650 | Tracey Denise Manigault | Psychologist | 8900 N Central Ave Ste 105, Phoenix, AZ 85020-2846 | 2017-05-17 |
| 1316326044 | Nicole Nielsen | Psychologist | 622 E Nicolet Ave, Phoenix, AZ 85020-4943 | 2015-05-27 |
| 1770915985 | Jill Larkin | Psychologist | 7747 W Pipestone Pl, Phoenix, AZ 85035-5096 | 2013-07-30 |
| 1639488570 | Jacqueline Relyea | Psychologist | 6550 S 27th Ave, Phoenix, AZ 85041-5287 | 2010-09-27 |
| 1740597541 | Kyle Vessell | Psychologist | 2625 E Cheryl Dr, Phoenix, AZ 85028-4319 | 2010-09-01 |
| 1972819084 | Carl Grasso | Psychologist | 31413 N 20th Ave, Phoenix, AZ 85085-7021 | 2010-08-26 |
| 1568778132 | Deborah Vogt Purscell | Psychologist | 1247 E Glenhaven Dr, Phoenix, AZ 85048-4734 | 2010-08-20 |
| 1548575426 | Casie Rene'e Blount | Psychologist | 3609 N 27th St, Phoenix, AZ 85016-6747 | 2010-08-16 |
| 1093034209 | Tiffani Allen | Psychologist | 1002 E Sheridan St, Phoenix, AZ 85006-1647 | 2010-05-27 |
| 1205164167 | Parul Saxena | Psychologist | 8525 W Osborn Road, Desert Horizon School, Phoenix, AZ 85037 | 2009-12-03 |
| Find all providers in PHOENIX | ||||
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| 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.