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General NPI Number Information
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NPI Number | 1295181071
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Entity Type | Individual
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Provider Name | KATI WIJDENES DNP
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Gender | Female
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 1530 E WILLIAMS FIELD RD STE 201-9
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City | GILBERT
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State | AZ
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Zip | 85295-1823
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Country | US
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Telephone | 480-418-0184
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Fax | 480-602-5656
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Provider Business Mailing Address
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Address Line | 2747 E UNIVERSITY DR UNIT 31505
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City | MESA
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State | AZ
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Zip | 85275-0270
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G175516
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP8449
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License Number State | AZ
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