Individual
KATHLEEN ELIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
250 E DUNLAP AVE, PHOENIX, AZ 85020-2825
(602) 943-2381
Mailing address
9225 N 3RD ST STE 300, PHOENIX, AZ 85020-2466
(602) 445-0751
(602) 424-8128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
236617
AZ
363LA2100X
Acute Care Nurse Practitioner
Primary
236617
AZ
363LG0600X
Gerontology Nurse Practitioner
236617
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003365
—
AZ
01
—
Z238145
PTAN
AZ
Enumeration date
02/07/2020
Last updated
05/03/2022
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