Provider Demographics
NPI:1255856803
Name:LAPA, KELLY A (FNP-C)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:LAPA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:907 N MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-2309
Mailing Address - Country:US
Mailing Address - Phone:480-789-2571
Mailing Address - Fax:573-240-9791
Practice Address - Street 1:4700 S MCCLINTOCK DR STE 140
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7375
Practice Address - Country:US
Practice Address - Phone:480-210-3407
Practice Address - Fax:573-240-9791
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAP10464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily