Provider Demographics
NPI:1447071535
Name:ST CLAIR, KELLY CAHILL (BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:CAHILL
Last Name:ST CLAIR
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 RUFOUS LN
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-7117
Mailing Address - Country:US
Mailing Address - Phone:480-326-6165
Mailing Address - Fax:480-422-2500
Practice Address - Street 1:83 RUFOUS LN
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-7117
Practice Address - Country:US
Practice Address - Phone:480-326-6165
Practice Address - Fax:480-422-2500
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN187409163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management