Healthcare Provider Details

I. General information

NPI: 1396426292
Provider Name (Legal Business Name): KATHERINE E DENISON AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 08/07/2025
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2946 E. BANNER GATEWAY DR
GILBERT AZ
85234
US

IV. Provider business mailing address

2946 E. BANNER GATEWAY DR
GILBERT AZ
85234
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-6444
  • Fax: 480-256-3359
Mailing address:
  • Phone: 480-256-6444
  • Fax: 480-256-3359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number295288
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: