Healthcare Provider Details
I. General information
NPI: 1912825092
Provider Name (Legal Business Name): KINDCARE PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14545 E GRAND AVE SUITE # 106
SURPRISE AZ
85374
US
IV. Provider business mailing address
PO BOX 2005
SURPRISE AZ
85378-2005
US
V. Phone/Fax
- Phone: 480-415-7042
- Fax:
- Phone: 480-415-7042
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEVIN
SY
Title or Position: PROVIDER/OWNER
Credential: FNP-C
Phone: 480-415-7042