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General NPI Number Information
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NPI Number | 1386507804
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Entity Type | Organization
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Legal Business Name | KMA MEDICAL AESTHETICS LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1955 COMMERCE CENTER CIR STE C
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City | PRESCOTT
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State | AZ
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Zip | 86301-7410
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Country | US
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Telephone | 928-929-2142
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Fax |
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Provider Business Mailing Address
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Address Line | 13215 N TRAIL BLAZER DR
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City | PRESCOTT
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State | AZ
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Zip | 86305-7964
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Country | US
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Telephone | 909-659-5025
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KATHLEEN ARNOLD
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Credential | CRNA, APRN
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Telephone | 909-659-5025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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