Kenworthey, Mary Ellen

Kenworthey, Mary Ellen is an individual health care provider with primary practice located at 2929 E Thomas Rd , Phoenix AZ 85016-8034. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology. Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology is her primary health care specialty. Kenworthey, Mary Ellen can be contacted via phone (602) 470-5000.

Contact Information

Primary practice address
2929 E Thomas Rd Phoenix AZ 85016-8034
Phone: (602) 470-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X RN043733 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X RN043733 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X AP0078 Arizona

Profile Details

NPI number 1184603342
LBN Legal business name Kenworthey, Mary Ellen
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2006
Last updated Mar 10th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184603342 NPPES
Arizona MEDICAID 760406

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