Individual provider · Type 1 NPI

Kelly Jo Lewis, NURSE PRACTITIONER

Primary Care Nurse Practitioner · Kingman, AZ

NPI number 1104389451 Active

Practice location

1510 N Stockton Hill Rd
Kingman, AZ 86401-5173

Fax (928) 753-1177

Mailing address

PO Box 1231
Tucson, AZ 85702-1231

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300X307837 (AZ)

Primary Care Nurse Practitioner: Definition to come...

17 other providers at this address

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About NPI 1104389451

Kelly Jo Lewis, NURSE PRACTITIONER's National Provider Identifier is 1104389451, issued on Apr 12, 2019. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Kingman, AZ. The record was last updated on May 1, 2026.