Individual
KEVIN KON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1066 N POWER RD, STE 101, MESA, AZ 85205
(480) 776-1588
Mailing address
27208 N 65TH DR, PHOENIX, AZ 85085
(623) 825-5022
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3082
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043383
—
AZ
Enumeration date
06/28/2006
Last updated
07/08/2007
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