Healthcare Provider Details

I. General information

NPI: 1336561828
Provider Name (Legal Business Name): KATHLEEN M FORGY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2014
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N. HIGLEY RD
GILBERT AZ
85234
US

IV. Provider business mailing address

1900 N HIGLEY RD
GILBERT AZ
85234-1604
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-3350
  • Fax:
Mailing address:
  • Phone: 480-256-3350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP5409
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP5409
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: