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General NPI Number Information
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NPI Number | 1023224078
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Entity Type | Individual
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Provider Name | KIMBERLY N WAERNESS R.PH
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13400 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5404
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Country | US
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Telephone | 480-301-8195
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Fax |
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Provider Business Mailing Address
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Address Line | 9227 E RUSTY SPUR PL
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-6603
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Country | US
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Telephone | 480-342-7084
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12665
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License Number State | AZ
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