Healthcare Provider Details

I. General information

NPI: 1962225649
Provider Name (Legal Business Name): KRISTI LYN BARTHELMESS MSN, APRN, ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5777 E MAYO BLVD
PHOENIX AZ
85054-4502
US

IV. Provider business mailing address

18119 W RUTH AVE
WADDELL AZ
85355-7534
US

V. Phone/Fax

Practice location:
  • Phone: 480-574-2823
  • Fax:
Mailing address:
  • Phone: 760-509-6713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number278087
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: