Healthcare Provider Details

I. General information

NPI: 1518451368
Provider Name (Legal Business Name): HEMA KALADEEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21803 N SCOTTSDALE RD STE 200
SCOTTSDALE AZ
85255-7446
US

IV. Provider business mailing address

21803 N SCOTTSDALE RD STE 200
SCOTTSDALE AZ
85255-7446
US

V. Phone/Fax

Practice location:
  • Phone: 480-500-1902
  • Fax: 480-500-1909
Mailing address:
  • Phone: 480-500-1902
  • Fax: 480-500-1909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP11332
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: