MS. KELLIE M EARLE P.A. (NPI# 1891995296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891995296 |
| Entity Type | Individual |
| Full Name | MS. KELLIE M EARLE P.A. |
| Credential | PA |
| Practice Address |
4135 So. Power Rd Suite 129 Mesa AZ 85212 |
| Mailing Address |
1156 So Fern Ct Gilbert AZ 85296 |
| Practice Telephone | 4807513091 |
| Practice Fax Number | 4807513095 |
| Mailing Telephone | 4807513091 |
| Mailing Fax Number | 4807513095 |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2016-04-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
010832 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
3636 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4135 SO. POWER RD SUITE 129 |
| City | MESA |
| State | AZ |
| Zip Code | 85212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610302 | West Point Optical Group | Optometrist | 10706 E Point Twenty-two Blvd, #107, Mesa, AZ 85212 | 2020-08-18 |
| 1215553565 | Andrew Eugene Pak | Dentist | 10664 East Point Twenty-two Blvd, Mesa, AZ 85212 | 2020-06-23 |
| 1588200265 | Signal Butte Kids Dentistry and Orthodontics, LLP | Dentist | 10664 E. Point Twenty Two Blvd, Mesa, AZ 85212 | 2019-11-18 |
| 1194371526 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 4316 S Signal Butte Rd, Mesa, AZ 85212 | 2019-08-12 |
| 1194200980 | Highbury Dental Management, LLC | Dentist | 4425 S Mountain Rd, Suite 109, Mesa, AZ 85212 | 2018-09-27 |
| 1033623541 | Latanya Olivia Edenburgs | Case Manager/Care Coordinator | 10436 E Radiant Ave., Mesa, AZ 85212 | 2017-11-20 |
| 1205355880 | Linda Okafor | Nurse Practitioner | 4719 S Calderon Circle, Mesa, AZ 85212 | 2017-09-14 |
| 1689121188 | Agh Mesa LLC | General Acute Care Hospital | 9130 East Elliot Road, Mesa, AZ 85212 | 2016-09-01 |
| 1861841918 | Ryan Blake | Dentist | 4425 S. Mountain Road, Ste 109, Mesa, AZ 85212 | 2016-06-09 |
| 1083089460 | White Glove Health | Nurse Practitioner | 2906 S Lynch Cr, Mesa, AZ 85212 | 2015-12-10 |
| Find all providers in zip 85212 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962986349 | Amber Lynn Maison | Physician Assistant | 4540 E Baseline Rd Ste 113, Mesa, AZ 85206-4617 | 2018-09-20 |
| 1821549619 | Briana Dawn Johnson | Physician Assistant | 455 N Mesa Dr Ste 16e, Mesa, AZ 85201-5995 | 2016-10-17 |
| 1659741031 | Jared Bevell | Physician Assistant | 844 E 7th Pl, Mesa, AZ 85203-6404 | 2015-09-29 |
| 1649507088 | Klint Layton Webb | Physician Assistant | 3130 E Baseline Rd Ste 103-104, Mesa, AZ 85204-7290 | 2009-11-05 |
| 1194961540 | Jeffrey R Smolin | Physician Assistant | 2034 S Alma School Rd Ste 2, Mesa, AZ 85210-4004 | 2009-01-06 |
| 1235389156 | Tessa M Tibben | Physician Assistant | 4855 E Brown Rd Ste 100, Mesa, AZ 85205-8007 | 2008-09-27 |
| 1639353808 | Brittany S Wheeler | Physician Assistant | 2310 E. Brown Rd, Mesa, AZ 85213 | 2007-12-24 |
| 1881778348 | Robert James Kalmbach | Physician Assistant | 4850 E Baseline #118, Mesa, AZ 85206 | 2006-10-24 |
| 1336255264 | Greenfield Family Medicine LLC | Physician Assistant | 1244 N. Greenfield Rd., Suite 104, Mesa, AZ 85205 | 2006-08-22 |
| 1932124435 | Eric P Johnson | Physician Assistant | 3514 N Power Road, Suite 118, Mesa, AZ 85215-2909 | 2006-07-13 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.