Provider Demographics
NPI:1043090905
Name:BARRAZA, KELSEY LYNN (ND)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:LYNN
Last Name:BARRAZA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 E RAY RD APT 529
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1227
Mailing Address - Country:US
Mailing Address - Phone:919-518-7115
Mailing Address - Fax:888-802-1404
Practice Address - Street 1:3150 E RAY RD APT 529
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-1227
Practice Address - Country:US
Practice Address - Phone:919-518-7115
Practice Address - Fax:888-802-1404
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23-1808175F00000X
AZ231808175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath