Healthcare Provider Details

I. General information

NPI: 1780044487
Provider Name (Legal Business Name): ABBY KASPAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 N 16TH ST SUITE 425
PHOENIX AZ
85020-4492
US

IV. Provider business mailing address

7720 N 16TH ST SUITE 425
PHOENIX AZ
85020-4492
US

V. Phone/Fax

Practice location:
  • Phone: 602-476-8926
  • Fax: 623-643-9236
Mailing address:
  • Phone: 602-476-8926
  • Fax: 623-643-9236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAP8794
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.0205318
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: