Healthcare Provider Details

I. General information

NPI: 1437926615
Provider Name (Legal Business Name): KRISTEN OLMSCHENK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 E. BELL RD.
PHOENIX AZ
85032
US

IV. Provider business mailing address

3247 E BELL RD
PHOENIX AZ
85032-2707
US

V. Phone/Fax

Practice location:
  • Phone: 602-255-7655
  • Fax:
Mailing address:
  • Phone: 602-255-7655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number300840
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: