Healthcare Provider Details

I. General information

NPI: 1982261186
Provider Name (Legal Business Name): KRISTINE FLETCHER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2629 N SCOTTSDALE RD
SCOTTSDALE AZ
85257-1370
US

IV. Provider business mailing address

7300 E EARLL DR UNIT 1005
SCOTTSDALE AZ
85251-7266
US

V. Phone/Fax

Practice location:
  • Phone: 623-334-4000
  • Fax:
Mailing address:
  • Phone: 480-353-8155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number224018
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: