Healthcare Provider Details

I. General information

NPI: 1326930827
Provider Name (Legal Business Name): KAYLEE A BIRD P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 N 3RD AVE # 200
PHOENIX AZ
85013-4434
US

IV. Provider business mailing address

2910 N 3RD AVE # 200
PHOENIX AZ
85013-4434
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-4630
  • Fax: 833-973-5424
Mailing address:
  • Phone: 602-406-4630
  • Fax: 833-973-5424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11846
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: