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General NPI Number Information
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NPI Number | 1386403079
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Entity Type | Organization
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Legal Business Name | KINGDOM WELLNESS & FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 03/15/2024
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 5422 W THUNDERBIRD RD STE 10
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City | GLENDALE
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State | AZ
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Zip | 85306-4717
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Country | US
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Telephone | 623-295-9737
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Fax | 623-666-6742
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Provider Business Mailing Address
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Address Line | 5422 W THUNDERBIRD RD STE 10
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City | GLENDALE
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State | AZ
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Zip | 85306-4717
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Country | US
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Telephone | 623-295-9737
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Fax | 623-666-6742
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Authorized Official
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Title or Position | OWNER
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Name | NANCY ASHBY
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Credential | FNP-C
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Telephone | 623-295-9737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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