Individual
MRS. KIMBERLY ANN COUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, FNP-C
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 623-1511
(602) 263-1637
Mailing address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 623-1511
(602) 263-1637
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
RN071137
AZ
363LF0000X
Family Nurse Practitioner
AP0237
AZ
363LF0000X
Family Nurse Practitioner
RN071137
AZ
367A00000X
Advanced Practice Midwife
Primary
AP0237
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
472556
—
AZ
01
—
AZ0143460
BCBS
AZ
Enumeration date
08/30/2006
Last updated
08/17/2022
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