Healthcare Provider Details

I. General information

NPI: 1346160215
Provider Name (Legal Business Name): KIMBERLY ANN STAPLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W MORNINGSIDE DR
PHOENIX AZ
85023-2341
US

IV. Provider business mailing address

3429 W STEINBECK DR
ANTHEM AZ
85086-2510
US

V. Phone/Fax

Practice location:
  • Phone: 602-467-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN171679
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: