Healthcare Provider Details

I. General information

NPI: 1346165966
Provider Name (Legal Business Name): KRISTEN BADONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 E BROADWAY RD STE 9
MESA AZ
85208-1156
US

IV. Provider business mailing address

1155 S POWER RD STE 114
MESA AZ
85206-3716
US

V. Phone/Fax

Practice location:
  • Phone: 480-981-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number344126
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: