Healthcare Provider Details

I. General information

NPI: 1982436929
Provider Name (Legal Business Name): KIRSTEN MARIE WILLENBRING NMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2034 E SOUTHERN AVE STE A
TEMPE AZ
85282-7527
US

IV. Provider business mailing address

2034 E SOUTHERN AVE STE A
TEMPE AZ
85282-7527
US

V. Phone/Fax

Practice location:
  • Phone: 480-442-0011
  • Fax: 480-470-1748
Mailing address:
  • Phone: 480-442-0011
  • Fax: 480-470-1748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: