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NPI Code Detail

MEDICARE: MS. KATHLEEN MICHELE PRESTON NP

MEDICARE: MS. KATHLEEN MICHELE PRESTON NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerAP11110AZ
2363LP0808XPsychiatric/Mental Health Nurse Practitioner19764CA

General Provider Information

NPI Number : 1376891432
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN MICHELE PRESTON NP
Provider Business Mailing Address
First Line : 725 S DOBSON RD STE 100
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-5676
Country : US
Telephone Number : 602-795-8700
Fax Number : 602-795-8701
Provider Business Practice Location Address
First Line : 725 S DOBSON RD STE 100
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-5676
Country : US
Telephone Number : 602-795-8700
Fax Number : 602-795-8701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2012
Last Update Date : 04/14/2025

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