Healthcare Provider Details

I. General information

NPI: 1295332179
Provider Name (Legal Business Name): KIMBERLY ROSE TOKARSKI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 W CHANDLER BLVD BLDG F
CHANDLER AZ
85226-3732
US

IV. Provider business mailing address

4045 W CHANDLER BLVD BLDG F
CHANDLER AZ
85226-3732
US

V. Phone/Fax

Practice location:
  • Phone: 480-917-3706
  • Fax: 480-353-2066
Mailing address:
  • Phone: 480-917-3706
  • Fax: 480-353-2066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number255132
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: