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General NPI Number Information
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NPI Number | 1477261709
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Entity Type | Individual
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Provider Name | STACI P KILPATRICK FNP
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Gender | Female
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 5450 S LAKESHORE DR STE 109
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City | TEMPE
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State | AZ
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Zip | 85283-5511
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Country | US
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Telephone | 602-717-0231
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Fax |
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Provider Business Mailing Address
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Address Line | 5450 S LAKESHORE DR STE 109
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City | TEMPE
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State | AZ
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Zip | 85283-5511
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Country | US
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Telephone | 602-717-0231
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 283666
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License Number State | AZ
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