Individual
KAITLIN M HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15525 N 83RD AVE STE 104, PEORIA, AZ 85382-5820
(480) 964-2273
(623) 505-3772
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
9257
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9257
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/29/2022
Last updated
07/02/2025
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