Healthcare Provider Details

I. General information

NPI: 1013670439
Provider Name (Legal Business Name): KRYSTAL ANN TARANTO DNP - FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3648 W ANTHEM WAY BLDG A-100C
ANTHEM AZ
85086-7001
US

IV. Provider business mailing address

3648 W ANTHEM WAY BLDG A-100C
ANTHEM AZ
85086-7001
US

V. Phone/Fax

Practice location:
  • Phone: 623-434-6444
  • Fax:
Mailing address:
  • Phone: 623-523-9622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number271621
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number212966
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: