=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770445538
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIRA DEES APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2025
-----------------------------------------------------
Last Update Date | 12/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5823 W EUGIE AVE STE A
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85304-1277
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-843-1265
-----------------------------------------------------
Fax | 602-843-1297
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5823 W EUGIE AVE STE A
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85304-1277
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-843-1265
-----------------------------------------------------
Fax | 602-843-1297
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | 329776
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 329776
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------