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General NPI Number Information
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NPI Number | 1417380346
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Entity Type | Individual
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Provider Name | PAMELA LYNN KIELBOWICZ NP
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Gender | Female
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 1345 E MAIN ST SUITE # 103
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City | MESA
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State | AZ
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Zip | 85203-8947
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Country | US
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Telephone | 480-223-0090
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Fax | 480-889-0088
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Provider Business Mailing Address
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Address Line | 10465 E PINE VALLEY DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-1703
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Country | US
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Telephone | 702-378-2275
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Fax | 480-889-0088
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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 | AP5120
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License Number State | AZ
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