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NPI Code Detail

MEDICARE: KIMBERLY D VANA FNP

MEDICARE:   KIMBERLY D VANA  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN036510AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407947104
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY D VANA FNP
Provider Business Mailing Address
First Line : 6320 W UNION HILLS DRIVE
Second Line : BLDG B SUITE 1000
City : GLENDALE
State : AZ
Zip : 85308-1096
Country : US
Telephone Number : 623-328-5908
Fax Number : 480-830-3901
Provider Business Practice Location Address
First Line : 6320 W UNION HILLS DRIVE
Second Line : BLDG B SUITE 1000
City : GLENDALE
State : AZ
Zip : 85308-1096
Country : US
Telephone Number : 623-328-5908
Fax Number : 480-830-3901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 03/09/2018

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Directions to “ KIMBERLY D VANA FNP” Practice Location

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