Healthcare Provider Details

I. General information

NPI: 1588132096
Provider Name (Legal Business Name): KRISTINA MARIE LEONARD AGACNP - BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINA MARIE REYNOLDS RN

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 N 92ND ST STE 300
SCOTTSDALE AZ
85258-4525
US

IV. Provider business mailing address

2500 W UTOPIA RD STE 100
PHOENIX AZ
85027-4172
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-7750
  • Fax: 480-882-5838
Mailing address:
  • Phone: 623-683-4462
  • Fax: 623-683-4963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number218593
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number218593
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number218593
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: