Provider Demographics
NPI:1669272589
Name:MEZA, KELLE L
Entity type:Individual
Prefix:MRS
First Name:KELLE
Middle Name:L
Last Name:MEZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9518
Mailing Address - Street 2:
Mailing Address - City:CHANDLER HEIGHTS
Mailing Address - State:AZ
Mailing Address - Zip Code:85127-9518
Mailing Address - Country:US
Mailing Address - Phone:623-692-0527
Mailing Address - Fax:623-288-5074
Practice Address - Street 1:22850 E MARSH RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-2237
Practice Address - Country:US
Practice Address - Phone:623-692-0527
Practice Address - Fax:623-288-5074
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy