MEDICARE: KIMBERLY ERIN MAGUIRE CHW,BHT,CPSS

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
1	172V00000X	Community Health Worker		AZ

General Provider Information

NPI Number	:	1598626145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ERIN MAGUIRE CHW,BHT,CPSS

Provider Business Mailing Address
First Line	:	5601 W WILSHIRE DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85035-2939
Country	:	US
Telephone Number	:	480-262-1828
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 W WILSHIRE DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85035-2939
Country	:	US
Telephone Number	:	480-262-1828
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2025
Last Update Date	:	12/15/2025

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