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General NPI Number Information
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NPI Number | 1396380366
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Entity Type | Individual
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Provider Name | KATHRYN HAVENS MSN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/13/2019
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 10117 N 92ND ST STE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4555
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Country | US
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Telephone | 480-614-5808
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Fax |
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Provider Business Mailing Address
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Address Line | 5056 E GALLOP WAY
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-0020
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Country | US
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Telephone | 978-239-6123
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 232607
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License Number State | AZ
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