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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. KELLI RAYNELL FAVATA, M.D.

Active

DR. KELLI RAYNELL FAVATA, M.D. is a 246XC2903X healthcare provider located in GILBERT, Arizona. NPI 1184822348 is currently active in the NPPES registry. Verify at CMS.

246XC2903X · GILBERT, AZ

Registration Details

NPI Number
1184822348
Provider Type
Individual
Gender
Female
NPI Issued
Jul 10, 2007 (19.112863622847 yrs)
Last Updated
Feb 15, 2025
Licenses
30177 (SC)
45344 (AZ)
45344 (AZ)

Practice Information

Address
3530 S VAL VISTA DR STE B210
GILBERT, AZ, 852977318
Browse AZ providers · Browse ZIP 85297
Phone
8009916117
Primary Specialty
246XC2903X
246XC2903X
Additional Specialty
Internal Medicine
Additional Specialty
246XC2903X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.