Newly enumerated
The official enumeration date falls within the documented new-enumeration window.
- Enumeration date is 13 days before observation
Type 1 individualNPI 1396664603
KELLY HALTORP
2355S0801X · APACHE JUNCTION, AZ
Why this profile is appearing now
Observed change signals
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 2355S0801X | 2355S0801X | Primary |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s