Healthcare Provider Details

I. General information

NPI: 1902859903
Provider Name (Legal Business Name): KATHRYN LYNN MCNEIL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ELLIOTT AVE W STE 500
SEATTLE WA
98119-4292
US

IV. Provider business mailing address

5210 E PIMA ST STE 200
TUCSON AZ
85712-3678
US

V. Phone/Fax

Practice location:
  • Phone: 425-615-6266
  • Fax:
Mailing address:
  • Phone: 520-975-1557
  • Fax: 520-838-0789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19610
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP1080
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN000885
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61406667
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP4639
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: