MEDICARE: KRISTIN HERTZOG

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
1	363LF0000X	Family Nurse Practitioner	340487	AZ

General Provider Information

NPI Number	:	1992638167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN HERTZOG

Provider Business Mailing Address
First Line	:	1579 E BROKEN BOW WAY
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85755-9307
Country	:	US
Telephone Number	:	520-877-1787
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 W CAMELBACK RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85017-1097
Country	:	US
Telephone Number	:	855-428-5673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

Similar Medicare Providers

1932267564 — JENNIFER LYNN WOMELDORF-DUNN MSNED, RN, CPN, CNE
Practice Location Address:

3300 W CAMELBACK RD # 6-220
PHOENIX, AZ
85017-1097

Practice Phone: 602-639-8295
Practice Fax:

1801918883 — TAMARA NOEL WISELY WHNP
Practice Location Address:

3300 W CAMELBACK RD BLDG 47
PHOENIX, AZ
85017-1097

Practice Phone: 602-639-6215
Practice Fax: 602-639-7830

1285989608 — LYNDEE JOHNSON FNP-C
Practice Location Address:

3300 W CAMELBACK RD BLDG 47
PHOENIX, AZ
85017-1097

Practice Phone: 602-639-6215
Practice Fax: 888-972-4657

1508293903 — CYNDIRAE DALY BRAUN FNP
Practice Location Address:

3300 W CAMELBACK RD BLDG 47
PHOENIX, AZ
85017-1097

Practice Phone: 602-639-6215
Practice Fax: 888-972-4657

1962806372 — STEPHANIE HERRICK KAYS FNP
Practice Location Address:

3300 W CAMELBACK RD BLDG 47
PHOENIX, AZ
85017-1097

Practice Phone: 602-639-6215
Practice Fax: 602-936-7830

1124501069 — GRAND CANYON UNIVERSITY
Practice Location Address:

3300 W CAMELBACK RD , HEALTH CENTER
PHOENIX, AZ
85017-1097

Practice Phone: 602-639-6215
Practice Fax: 602-639-7830

Directions to “ KRISTIN HERTZOG ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.