Healthcare Provider Details

I. General information

NPI: 1184408106
Provider Name (Legal Business Name): KAITLYNN ELAINE ESLINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14011 N CORAL GABLES DR
PHOENIX AZ
85023-6275
US

IV. Provider business mailing address

14011 N CORAL GABLES DR
PHOENIX AZ
85023-6275
US

V. Phone/Fax

Practice location:
  • Phone: 512-217-7783
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number277027
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: